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Zhou J, Hou Z, Tian C, Zhu Z, Ye M, Chen S, Yang H, Zhang X, Zhang B. Review of tracer kinetic models in evaluation of gliomas using dynamic contrast-enhanced imaging. Front Oncol 2024; 14:1380793. [PMID: 38947892 PMCID: PMC11211364 DOI: 10.3389/fonc.2024.1380793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 05/29/2024] [Indexed: 07/02/2024] Open
Abstract
Glioma is the most common type of primary malignant tumor of the central nervous system (CNS), and is characterized by high malignancy, high recurrence rate and poor survival. Conventional imaging techniques only provide information regarding the anatomical location, morphological characteristics, and enhancement patterns. In contrast, advanced imaging techniques such as dynamic contrast-enhanced (DCE) MRI or DCE CT can reflect tissue microcirculation, including tumor vascular hyperplasia and vessel permeability. Although several studies have used DCE imaging to evaluate gliomas, the results of data analysis using conventional tracer kinetic models (TKMs) such as Tofts or extended-Tofts model (ETM) have been ambiguous. More advanced models such as Brix's conventional two-compartment model (Brix), tissue homogeneity model (TH) and distributed parameter (DP) model have been developed, but their application in clinical trials has been limited. This review attempts to appraise issues on glioma studies using conventional TKMs, such as Tofts or ETM model, highlight advancement of DCE imaging techniques and provides insights on the clinical value of glioma management using more advanced TKMs.
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Affiliation(s)
- Jianan Zhou
- Department of Radiology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, China
- Medical Imaging Center, Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Zujun Hou
- The Jiangsu Key Laboratory of Medical Optics, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, China
| | - Chuanshuai Tian
- Department of Radiology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, China
- Medical Imaging Center, Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Zhengyang Zhu
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, China
- Medical Imaging Center, Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Meiping Ye
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, China
- Medical Imaging Center, Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Sixuan Chen
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, China
- Medical Imaging Center, Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Huiquan Yang
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, China
- Medical Imaging Center, Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Xin Zhang
- Department of Radiology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, China
- Medical Imaging Center, Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Bing Zhang
- Department of Radiology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, China
- Medical Imaging Center, Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
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Almutlaq ZM, Bacon SE, Wilson DJ, Sharma N, Dondo T, Buckley DL. The relationship between parameters measured using intravoxel incoherent motion and dynamic contrast-enhanced MRI in patients with breast cancer undergoing neoadjuvant chemotherapy: a longitudinal cohort study. Front Oncol 2024; 14:1356173. [PMID: 38860001 PMCID: PMC11163445 DOI: 10.3389/fonc.2024.1356173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 05/07/2024] [Indexed: 06/12/2024] Open
Abstract
Purpose The primary aim of this study was to explore whether intravoxel incoherent motion (IVIM) can offer a contrast-agent-free alternative to dynamic contrast-enhanced (DCE)-MRI for measuring breast tumor perfusion. The secondary aim was to investigate the relationship between tissue diffusion measures from DWI and DCE-MRI measures of the tissue interstitial and extracellular volume fractions. Materials and methods A total of 108 paired DWI and DCE-MRI scans were acquired at 1.5 T from 40 patients with primary breast cancer (median age: 44.5 years) before and during neoadjuvant chemotherapy (NACT). DWI parameters included apparent diffusion coefficient (ADC), tissue diffusion (Dt), pseudo-diffusion coefficient (Dp), perfused fraction (f), and the product f×Dp (microvascular blood flow). DCE-MRI parameters included blood flow (Fb), blood volume fraction (vb), interstitial volume fraction (ve) and extracellular volume fraction (vd). All were extracted from three tumor regions of interest (whole-tumor, ADC cold-spot, and DCE-MRI hot-spot) at three MRI visits: pre-treatment, after one, and three cycles of NACT. Spearman's rank correlation was used for assessing between-subject correlations (r), while repeated measures correlation was employed to assess within-subject correlations (rrm) across visits between DWI and DCE-MRI parameters in each region. Results No statistically significant between-subject or within-subject correlation was found between the perfusion parameters estimated by IVIM and DCE-MRI (f versus vb and f×Dp versus Fb; P=0.07-0.81). Significant moderate positive between-subject and within-subject correlations were observed between ADC and ve (r=0.461, rrm=0.597) and between Dt and ve (r=0.405, rrm=0.514) as well as moderate positive within-subject correlations between ADC and vd and between Dt and vd (rrm=0.619 and 0.564, respectively) in the whole-tumor region. Conclusion No correlations were observed between the perfusion parameters estimated by IVIM and DCE-MRI. This may be attributed to imprecise estimates of fxDp and vb, or an underlying difference in what IVIM and DCE-MRI measure. Care should be taken when interpreting the IVIM parameters (f and f×Dp) as surrogates for those measured using DCE-MRI. However, the moderate positive correlations found between ADC and Dt and the DCE-MRI parameters ve and vd confirms the expectation that as the interstitial and extracellular volume fractions increase, water diffusion increases.
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Affiliation(s)
- Zyad M. Almutlaq
- Biomedical Imaging, Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM), University of Leeds, Leeds, United Kingdom
- Radiological Sciences Department, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Sarah E. Bacon
- Department of Medical Physics & Engineering, Leeds Teaching Hospitals National Health Service (NHS) Trust, Leeds, United Kingdom
| | - Daniel J. Wilson
- Department of Medical Physics & Engineering, Leeds Teaching Hospitals National Health Service (NHS) Trust, Leeds, United Kingdom
| | - Nisha Sharma
- Department of Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Tatendashe Dondo
- Clinical and Population Sciences Department, LICAMM, University of Leeds, Leeds, United Kingdom
| | - David L. Buckley
- Biomedical Imaging, Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM), University of Leeds, Leeds, United Kingdom
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Kalisvaart GM, Evenhuis RE, Grootjans W, Van Den Berghe T, Callens M, Bovée JVMG, Creytens D, Gelderblom H, Speetjens FM, Lapeire L, Sys G, Fiocco M, Verstraete KL, van de Sande MAJ, Bloem JL. Relative Wash-In Rate in Dynamic Contrast-Enhanced Magnetic Resonance Imaging as a New Prognostic Biomarker for Event-Free Survival in 82 Patients with Osteosarcoma: A Multicenter Study. Cancers (Basel) 2024; 16:1954. [PMID: 38893075 PMCID: PMC11171179 DOI: 10.3390/cancers16111954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 05/17/2024] [Accepted: 05/18/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND The decreased perfusion of osteosarcoma in dynamic contrast-enhanced (DCE) MRI, reflecting a good histological response to neoadjuvant chemotherapy, has been described. PURPOSE In this study, we aim to explore the potential of the relative wash-in rate as a prognostic factor for event-free survival (EFS). METHODS Skeletal high-grade osteosarcoma patients, treated in two tertiary referral centers between 2005 and 2022, were retrospectively included. The relative wash-in rate (rWIR) was determined with DCE-MRI before, after, or during the second cycle of chemotherapy (pre-resection). A previously determined cut-off was used to categorize patients, where rWIR < 2.3 was considered poor and rWIR ≥ 2.3 a good radiological response. EFS was defined as the time from resection to the first event: local recurrence, new metastases, or tumor-related death. EFS was estimated using Kaplan-Meier's methodology. Multivariate Cox proportional hazard model was used to estimate the effect of histological response and rWIR on EFS, adjusted for traditional prognostic factors. RESULTS Eighty-two patients (median age: 17 years; IQR: 14-28) were included. The median follow-up duration was 11.8 years (95% CI: 11.0-12.7). During follow-up, 33 events occurred. Poor histological response was not significantly associated with EFS (HR: 1.8; 95% CI: 0.9-3.8), whereas a poor radiological response was associated with a worse EFS (HR: 2.4; 95% CI: 1.1-5.0). In a subpopulation without initial metastases, the binary assessment of rWIR approached statistical significance (HR: 2.3; 95% CI: 1.0-5.2), whereas its continuous evaluation demonstrated a significant association between higher rWIR and improved EFS (HR: 0.7; 95% CI: 0.5-0.9), underlining the effect of response to chemotherapy. The 2- and 5-year EFS for patients with a rWIR ≥ 2.3 were 85% and 75% versus 55% and 50% for patients with a rWIR < 2.3. CONCLUSION The predicted poor chemo response with MRI (rWIR < 2.3) is associated with shorter EFS even when adjusted for known clinical covariates and shows similar results to histological response evaluation. rWIR is a potential tool for future response-based individualized healthcare in osteosarcoma patients before surgical resection.
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Affiliation(s)
- Gijsbert M. Kalisvaart
- Department of Radiology, Leiden University Medical Center, 2333 Leiden, The Netherlands; (G.M.K.)
| | - Richard E. Evenhuis
- Department of Orthopedic Surgery, Leiden University Medical Center, Albinusdreef 2, 2333 Leiden, The Netherlands
| | - Willem Grootjans
- Department of Radiology, Leiden University Medical Center, 2333 Leiden, The Netherlands; (G.M.K.)
| | | | - Martijn Callens
- Department of Radiology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Judith V. M. G. Bovée
- Department of Pathology, Leiden University Medical Center, 2333 Leiden, The Netherlands
| | - David Creytens
- Department of Pathology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Hans Gelderblom
- Department of Medical Oncology, Leiden University Medical Center, 2333 Leiden, The Netherlands
| | - Frank M. Speetjens
- Department of Medical Oncology, Leiden University Medical Center, 2333 Leiden, The Netherlands
| | - Lore Lapeire
- Department of Medical Oncology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Gwen Sys
- Department of Orthopedic Surgery and Traumatology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Marta Fiocco
- Department of Biomedical Science, Section Medical Statistics, Leiden University Medical Center, 2333 Leiden, The Netherlands
- Center for Pediatric Oncology, Princess Maxima Center, 3584 Utrecht, The Netherlands
- Mathematical Institute, Leiden University, 2300 Leiden, The Netherlands
| | | | - Michiel A. J. van de Sande
- Department of Orthopedic Surgery, Leiden University Medical Center, Albinusdreef 2, 2333 Leiden, The Netherlands
- Center for Pediatric Oncology, Princess Maxima Center, 3584 Utrecht, The Netherlands
| | - Johan L. Bloem
- Department of Radiology, Leiden University Medical Center, 2333 Leiden, The Netherlands; (G.M.K.)
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Gao A, Wang H, Zhang X, Wang T, Chen L, Hao J, Zhou R, Yang Z, Yue B, Hao D. Applying dynamic contrast-enhanced MRI tracer kinetic models to differentiate benign and malignant soft tissue tumors. Cancer Imaging 2024; 24:64. [PMID: 38773660 PMCID: PMC11107050 DOI: 10.1186/s40644-024-00710-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 05/11/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND To explore the potential of different quantitative dynamic contrast-enhanced (qDCE)-MRI tracer kinetic (TK) models and qDCE parameters in discriminating benign from malignant soft tissue tumors (STTs). METHODS This research included 92 patients (41females, 51 males; age range 16-86 years, mean age 51.24 years) with STTs. The qDCE parameters (Ktrans, Kep, Ve, Vp, F, PS, MTT and E) for regions of interest of STTs were estimated by using the following TK models: Tofts (TOFTS), Extended Tofts (EXTOFTS), adiabatic tissue homogeneity (ATH), conventional compartmental (CC), and distributed parameter (DP). We established a comprehensive model combining the morphologic features, time-signal intensity curve shape, and optimal qDCE parameters. The capacities to identify benign and malignant STTs was evaluated using the area under the curve (AUC), degree of accuracy, and the analysis of the decision curve. RESULTS TOFTS-Ktrans, EXTOFTS-Ktrans, EXTOFTS-Vp, CC-Vp and DP-Vp demonstrated good diagnostic performance among the qDCE parameters. Compared with the other TK models, the DP model has a higher AUC and a greater level of accuracy. The comprehensive model (AUC, 0.936, 0.884-0.988) demonstrated superiority in discriminating benign and malignant STTs, outperforming the qDCE models (AUC, 0.899-0.915) and the traditional imaging model (AUC, 0.802, 0.712-0.891) alone. CONCLUSIONS Various TK models successfully distinguish benign from malignant STTs. The comprehensive model is a noninvasive approach incorporating morphological imaging aspects and qDCE parameters, and shows significant potential for further development.
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Affiliation(s)
- Aixin Gao
- Department of Radiology, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, Shandong, China
| | - Hexiang Wang
- Department of Radiology, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, Shandong, China
| | - Xiuyun Zhang
- Department of Clinic Lab, Qingdao Cancer Hospital, Qingdao, Shandong, China
| | - Tongyu Wang
- Department of Radiology, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, Shandong, China
| | - Liuyang Chen
- Fisca Healthcare (nanjing) Co., Ltd, Nanjing, Jiangsu, China
| | - Jingwei Hao
- Department of Radiology, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, Shandong, China
| | - Ruizhi Zhou
- Department of Radiology, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, Shandong, China
| | - Zhitao Yang
- Department of Radiology, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, Shandong, China
| | - Bin Yue
- Department of Bone Oncology, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, Shandong, China.
| | - Dapeng Hao
- Department of Radiology, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, Shandong, China.
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Clemente A, Selva G, Berks M, Morrone F, Morrone AA, Aulisa MDC, Bliakharskaia E, De Nicola A, Tartaro A, Summers PE. Comparison of Early Contrast Enhancement Models in Ultrafast Dynamic Contrast-Enhanced Magnetic Resonance Imaging of Prostate Cancer. Diagnostics (Basel) 2024; 14:870. [PMID: 38732285 PMCID: PMC11083228 DOI: 10.3390/diagnostics14090870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 04/05/2024] [Accepted: 04/08/2024] [Indexed: 05/13/2024] Open
Abstract
Tofts models have failed to produce reliable quantitative markers for prostate cancer. We examined the differences between prostate zones and lesion PI-RADS categories and grade group (GG) using regions of interest drawn in tumor and normal-appearing tissue for a two-compartment uptake (2CU) model (including plasma volume (vp), plasma flow (Fp), permeability surface area product (PS), plasma mean transit time (MTTp), capillary transit time (Tc), extraction fraction (E), and transfer constant (Ktrans)) and exponential (amplitude (A), arrival time (t0), and enhancement rate (α)), sigmoidal (amplitude (A0), center time relative to arrival time (A1 - T0), and slope (A2)), and empirical mathematical models, and time to peak (TTP) parameters fitted to high temporal resolution (1.695 s) DCE-MRI data. In 25 patients with 35 PI-RADS category 3 or higher tumors, we found Fp and α differed between peripheral and transition zones. Parameters Fp, MTTp, Tc, E, α, A1 - T0, and A2 and TTP all showed associations with PI-RADS categories and with GG in the PZ when normal-appearing regions were included in the non-cancer GG. PS and Ktrans were not associated with any PI-RADS category or GG. This pilot study suggests early enhancement parameters derived from ultrafast DCE-MRI may become markers of prostate cancer.
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Affiliation(s)
- Alfredo Clemente
- Radiology Unit, Centro Medicina Nucleare N1, “Centro Morrone”, 81100 Caserta, Italy; (A.C.); (G.S.)
| | - Guerino Selva
- Radiology Unit, Centro Medicina Nucleare N1, “Centro Morrone”, 81100 Caserta, Italy; (A.C.); (G.S.)
| | - Michael Berks
- Quantitative Biomedical Imaging Laboratory, Division of Cancer Sciences, University of Manchester, Manchester M13 9PL, UK;
| | - Federica Morrone
- Radiology Unit, Centro Radiologico Vega, “Centro Morrone”, 81100 Caserta, Italy; (F.M.); (A.A.M.)
| | | | | | | | - Andrea De Nicola
- Radiology Unit, SS. Annunziata Hospital, ASL Lanciano Vasto Chieti, 66100 Chieti, Italy;
| | - Armando Tartaro
- Department of Clinical, Oral Sciences and Biotechnology, University “G. d’Annunzio”, 66100 Chieti, Italy;
- MRI Unit, Santissima Trinità Hospital, ASL Pescara, 65026 Popoli, Italy
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Van Den Berghe T, Verberckmoes B, Kint N, Wallaert S, De Vos N, Algoet C, Behaeghe M, Dutoit J, Van Roy N, Vlummens P, Dendooven A, Van Dorpe J, Offner F, Verstraete K. Predicting cytogenetic risk in multiple myeloma using conventional whole-body MRI, spinal dynamic contrast-enhanced MRI, and spinal diffusion-weighted imaging. Insights Imaging 2024; 15:106. [PMID: 38597979 PMCID: PMC11006637 DOI: 10.1186/s13244-024-01672-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 03/08/2024] [Indexed: 04/11/2024] Open
Abstract
OBJECTIVES Cytogenetic abnormalities are predictors of poor prognosis in multiple myeloma (MM). This paper aims to build and validate a multiparametric conventional and functional whole-body MRI-based prediction model for cytogenetic risk classification in newly diagnosed MM. METHODS Patients with newly diagnosed MM who underwent multiparametric conventional whole-body MRI, spinal dynamic contrast-enhanced (DCE-)MRI, spinal diffusion-weighted MRI (DWI) and had genetic analysis were retrospectively included (2011-2020/Ghent University Hospital/Belgium). Patients were stratified into standard versus intermediate/high cytogenetic risk groups. After segmentation, 303 MRI features were extracted. Univariate and model-based methods were evaluated for feature and model selection. Testing was performed using receiver operating characteristic (ROC) and precision-recall curves. Models comparing the performance for genetic risk classification of the entire MRI protocol and of all MRI sequences separately were evaluated, including all features. Four final models, including only the top three most predictive features, were evaluated. RESULTS Thirty-one patients were enrolled (mean age 66 ± 7 years, 15 men, 13 intermediate-/high-risk genetics). None of the univariate models and none of the models with all features included achieved good performance. The best performing model with only the three most predictive features and including all MRI sequences reached a ROC-area-under-the-curve of 0.80 and precision-recall-area-under-the-curve of 0.79. The highest statistical performance was reached when all three MRI sequences were combined (conventional whole-body MRI + DCE-MRI + DWI). Conventional MRI always outperformed the other sequences. DCE-MRI always outperformed DWI, except for specificity. CONCLUSIONS A multiparametric MRI-based model has a better performance in the noninvasive prediction of high-risk cytogenetics in newly diagnosed MM than conventional MRI alone. CRITICAL RELEVANCE STATEMENT An elaborate multiparametric MRI-based model performs better than conventional MRI alone for the noninvasive prediction of high-risk cytogenetics in newly diagnosed multiple myeloma; this opens opportunities to assess genetic heterogeneity thus overcoming sampling bias. KEY POINTS • Standard genetic techniques in multiple myeloma patients suffer from sampling bias due to tumoral heterogeneity. • Multiparametric MRI noninvasively predicts genetic risk in multiple myeloma. • Combined conventional anatomical MRI, DCE-MRI, and DWI had the highest statistical performance to predict genetic risk. • Conventional MRI alone always outperformed DCE-MRI and DWI separately to predict genetic risk. DCE-MRI alone always outperformed DWI separately, except for the parameter specificity to predict genetic risk. • This multiparametric MRI-based genetic risk prediction model opens opportunities to noninvasively assess genetic heterogeneity thereby overcoming sampling bias in predicting genetic risk in multiple myeloma.
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Affiliation(s)
- Thomas Van Den Berghe
- Department of Radiology and Medical Imaging, Ghent University Hospital, Building -1K12, Corneel Heymanslaan 10, Ghent, B-9000, Belgium.
| | - Bert Verberckmoes
- Department of Radiology and Medical Imaging, Ghent University Hospital, Building -1K12, Corneel Heymanslaan 10, Ghent, B-9000, Belgium
| | - Nicolas Kint
- Department of Clinical Hematology, Ghent University Hospital, Corneel Heymanslaan 10, Ghent, B-9000, Belgium
| | - Steven Wallaert
- Department of Biostatistics, Ghent University Hospital, Corneel Heymanslaan 10, Ghent, B-9000, Belgium
| | - Nicolas De Vos
- Department of Radiology and Medical Imaging, Ghent University Hospital, Building -1K12, Corneel Heymanslaan 10, Ghent, B-9000, Belgium
| | - Chloé Algoet
- Department of Radiology and Medical Imaging, Ghent University Hospital, Building -1K12, Corneel Heymanslaan 10, Ghent, B-9000, Belgium
| | - Maxim Behaeghe
- Department of Radiology and Medical Imaging, Ghent University Hospital, Building -1K12, Corneel Heymanslaan 10, Ghent, B-9000, Belgium
| | - Julie Dutoit
- Department of Radiology and Medical Imaging, Ghent University Hospital, Building -1K12, Corneel Heymanslaan 10, Ghent, B-9000, Belgium
| | - Nadine Van Roy
- Center for Medical Genetics, Ghent University Hospital, Corneel Heymanslaan 10, Ghent, B-9000, Belgium
| | - Philip Vlummens
- Department of Clinical Hematology, Ghent University Hospital, Corneel Heymanslaan 10, Ghent, B-9000, Belgium
| | - Amélie Dendooven
- Department of Pathology, Ghent University Hospital, Corneel Heymanslaan 10, Ghent, B-9000, Belgium
| | - Jo Van Dorpe
- Department of Pathology, Ghent University Hospital, Corneel Heymanslaan 10, Ghent, B-9000, Belgium
| | - Fritz Offner
- Department of Clinical Hematology, Ghent University Hospital, Corneel Heymanslaan 10, Ghent, B-9000, Belgium
| | - Koenraad Verstraete
- Department of Radiology and Medical Imaging, Ghent University Hospital, Building -1K12, Corneel Heymanslaan 10, Ghent, B-9000, Belgium
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Jahn M, Layer G. [Multiparametric magnetic resonance imaging for hepatocellular carcinoma, part 1 : Morphology and dynamic perfusion imaging in primary diagnostics and treatment monitoring]. RADIOLOGIE (HEIDELBERG, GERMANY) 2024; 64:321-332. [PMID: 38502373 DOI: 10.1007/s00117-024-01285-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/20/2024] [Indexed: 03/21/2024]
Abstract
Radiology plays a key role in the diagnosis and monitoring of hepatocellular carcinoma (HCC). Ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) are used to identify HCC lesions. Multiparametric MRI provides detailed insights into the tumor biology through the analysis of morphology, perfusion and diffusion. In this way preoperative decisions can be optimized. The guidelines recommend using contrast-enhanced MRI or ultrasound for the diagnosis of HCC. The preferred method is MRI due to its superiority in the detection of small lesions The treatment response is evaluated using modified response evaluation criteria for solid tumors (RECIST) and the European Association for the Study of the Liver (EASL) criteria. The use of multiparametric MRI in conjunction with the liver imaging reporting and data system (LI-RADS) plays overall a central role in the precise diagnosis and monitoring of the treatment of HCC.
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Affiliation(s)
- Mona Jahn
- Zentralinstitut für Diagnostische und Interventionelle Radiologie, Klinikum der Stadt Ludwigshafen am Rhein gGmbH, Bremserstraße 79, 67063, Ludwigshafen, Deutschland
| | - Günter Layer
- Zentralinstitut für Diagnostische und Interventionelle Radiologie, Klinikum der Stadt Ludwigshafen am Rhein gGmbH, Bremserstraße 79, 67063, Ludwigshafen, Deutschland
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Sankaralayam DS, Ramaniharan AK, Gupta RK, Patir R, Ahlawat S, Vaishya S, Singh A. Evaluating the Role of Leakage Correction of Hemodynamic Parameters derived from Dynamic Contrast Enhanced MRI for Glioma Grading. J Magn Reson Imaging 2024. [PMID: 38461487 DOI: 10.1002/jmri.29338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 02/22/2024] [Accepted: 02/22/2024] [Indexed: 03/12/2024] Open
Affiliation(s)
- Dinil Sasi Sankaralayam
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, India
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Anandh K Ramaniharan
- Philips Innovation Campus, Philips Healthcare India Private Limited, Bangalore, Karnataka, India
| | - Rakesh Kumar Gupta
- Department of Radiology and Imaging, Fortis Memorial Research Institute, Gurugram, Haryana, India
| | - Rana Patir
- Department of Neurosurgery, Fortis Memorial Research Institute, Gurugram, Haryana, India
| | - Sunita Ahlawat
- SRL Diagnostics, Fortis Memorial Research Institute, Gurugram, Haryana, India
| | - Sandeep Vaishya
- Department of Radiology and Imaging, Fortis Memorial Research Institute, Gurugram, Haryana, India
| | - Anup Singh
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, India
- Department of Biomedical Engineering, All India Institute of Medical Sciences, New Delhi, India
- Yardi School of Artificial Intelligence, Indian Institute of Technology Delhi, New Delhi, India
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Chen X, Xu J, Guo S, Zhang S, Wang H, Shen P, Shang Y, Tan M, Geng Y. Blood-brain barrier permeability by CT perfusion predicts parenchymal hematoma after recanalization with thrombectomy. J Neuroimaging 2024; 34:241-248. [PMID: 38018876 DOI: 10.1111/jon.13172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/13/2023] [Accepted: 11/13/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND AND PURPOSE Parenchymal hematoma is a dreaded complication of mechanical thrombectomy after acute ischemic stroke. This study evaluated whether blood-brain barrier permeability measurements based on CT perfusion could be used as predictors of parenchymal hematoma after successful recanalization and compared the predictive value of various permeability parameters in patients with acute ischemic stroke. METHODS We enrolled 53 patients with acute ischemic stroke who underwent mechanical thrombectomy and achieved successful recanalization. Each patient underwent CT, CT angiography, and CT perfusion imaging before treatment. We used relative volume transfer constant (rKtrans ) values, relative permeability-surface area product (rP·S), and relative extraction fraction (rE) to evaluate preoperative blood-brain barrier permeability in the delayed perfusion area. RESULTS Overall, 22 patients (37.7%) developed hemorrhagic transformation after surgery, including 10 patients (16.9%) with hemorrhagic infarction and 11 patients (20.8%) with parenchymal hematoma. The rP·S, rKtrans , and rE of the hypoperfusion area in the parenchymal hematoma group were significantly higher than those in the hemorrhagic infarction and no-hemorrhage transformation groups (p < .01). We found that rE and rP·S were superior to rKtrans in predicting parenchymal hematoma transformation after thrombectomy (P·S area under the curve [AUC] .844 vs. rKtrans AUC .753, z = 2.064, p = .039; rE AUC .907 vs. rKtrans AUC .753, z = 2.399, p = .017). CONCLUSIONS Patients with parenchymal hematoma after mechanical thrombectomy had higher blood-brain barrier permeability in hypoperfusion areas. Among blood-brain barrier permeability measurement parameters, rP·S and rE showed better accuracy for parenchymal hematoma prediction.
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Affiliation(s)
- Xinyi Chen
- Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jie Xu
- Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Shunyuan Guo
- Center for Rehabilitation Medicine, Department of Neurology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China
| | - Sheng Zhang
- Center for Rehabilitation Medicine, Department of Neurology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China
| | - Huiyuan Wang
- Department of Clinical Medicine, Bengbu Medical College, Bengbu, China
| | - Panpan Shen
- Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yafei Shang
- Department of Clinical Medicine, Bengbu Medical College, Bengbu, China
| | - Mingming Tan
- Zhejiang Provincial People's Hospital, Department of Quality Management, Hangzhou, China
| | - Yu Geng
- Center for Rehabilitation Medicine, Department of Neurology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China
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10
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Mooshage CM, Schimpfle L, Kender Z, Tsilingiris D, Aziz-Safaie T, Hohmann A, Szendroedi J, Nawroth P, Sturm V, Heiland S, Bendszus M, Kopf S, Kurz FT, Jende JME. Association of Small Fiber Function with Microvascular Perfusion of Peripheral Nerves in Patients with Type 2 Diabetes : Study using Quantitative Sensory Testing and Magnetic Resonance Neurography. Clin Neuroradiol 2024; 34:55-66. [PMID: 37548682 PMCID: PMC10881621 DOI: 10.1007/s00062-023-01328-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 06/19/2023] [Indexed: 08/08/2023]
Abstract
INTRODUCTION/AIMS Diabetic small fiber neuropathy (SFN) is caused by damage to thinly myelinated A‑fibers (δ) and unmyelinated C‑fibers. This study aimed to assess associations between quantitative sensory testing (QST) and parameters of peripheral nerve perfusion obtained from dynamic contrast enhanced (DCE) magnetic resonance neurography (MRN) in type 2 diabetes patients with and without SFN. METHODS A total of 18 patients with type 2 diabetes (T2D, 8 with SFN, 10 without SFN) and 10 healthy controls (HC) took part in this cross-sectional single-center study and underwent QST of the right leg and DCE-MRN of the right thigh with subsequent calculation of the sciatic nerve constant of capillary permeability (Ktrans), extravascular extracellular volume fraction (Ve), and plasma volume fraction (Vp). RESULTS The Ktrans (HC 0.031 min-1 ± 0.009, T2D 0.043 min-1 ± 0.015; p = 0.033) and Ve (HC 1.2% ± 1.5, T2D: 4.1% ± 5.1; p = 0.027) were lower in T2D patients compared to controls. In T2D patients, compound z‑scores of thermal and mechanical detection correlated with Ktrans (r = 0.73; p = 0.001, and r = 0.57; p = 0.018, respectively) and Ve (r = 0.67; p = 0.002, and r = 0.69; p = 0.003, respectively). Compound z‑scores of thermal pain and Vp (r = -0.57; p = 0.015) correlated negatively. DISCUSSION The findings suggest that parameters of peripheral nerve microcirculation are related to different symptoms in SFN: A reduced capillary permeability may result in a loss of function related to insufficient nutritional supply, whereas increased capillary permeability may be accompanied by painful symptoms related to a gain of function.
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Affiliation(s)
- Christoph M Mooshage
- Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Lukas Schimpfle
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
- German Center of Diabetes Research, associated partner in the DZD, Munich-Neuherberg, Germany
- Institute for Diabetes and Cancer (IDC), Helmholtz Diabetes Center, Helmholtz Center, Munich, Neuherberg, Munich, Germany
| | - Zoltan Kender
- German Center of Diabetes Research, associated partner in the DZD, Munich-Neuherberg, Germany
- Institute for Diabetes and Cancer (IDC), Helmholtz Diabetes Center, Helmholtz Center, Munich, Neuherberg, Munich, Germany
| | - Dimitrios Tsilingiris
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Taraneh Aziz-Safaie
- Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Anja Hohmann
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - Julia Szendroedi
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
- German Center of Diabetes Research, associated partner in the DZD, Munich-Neuherberg, Germany
- Joint Heidelberg-IDC Translational Diabetes Program, Inner Medicine 1, Heidelberg University Hospital, Heidelberg, Germany
| | - Peter Nawroth
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
- German Center of Diabetes Research, associated partner in the DZD, Munich-Neuherberg, Germany
- Joint Heidelberg-IDC Translational Diabetes Program, Inner Medicine 1, Heidelberg University Hospital, Heidelberg, Germany
| | - Volker Sturm
- Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
- Department of Neuroradiology, Division of Experimental Radiology, Heidelberg, Germany
| | - Sabine Heiland
- Department of Neuroradiology, Division of Experimental Radiology, Heidelberg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Stefan Kopf
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
- German Center of Diabetes Research, associated partner in the DZD, Munich-Neuherberg, Germany
- Institute for Diabetes and Cancer (IDC), Helmholtz Diabetes Center, Helmholtz Center, Munich, Neuherberg, Munich, Germany
| | - Felix T Kurz
- Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
- German Cancer Research Center, Heidelberg, Germany
| | - Johann M E Jende
- Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
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11
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Ramachandran A, Hussain H, Seiberlich N, Gulani V. Perfusion MR Imaging of Liver: Principles and Clinical Applications. Magn Reson Imaging Clin N Am 2024; 32:151-160. [PMID: 38007277 DOI: 10.1016/j.mric.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2023]
Abstract
Perfusion imaging techniques provide quantitative characterization of tissue microvasculature. Perfusion MR of liver is particularly challenging because of dual afferent flow, need for large organ high-resolution coverage, and significant movement with respiration. The most common MR technique used for quantifying liver perfusion is dynamic contrast-enhanced MR imaging. Here, the authors describe the various perfusion MR models of the liver, the basic concepts behind implementing a perfusion acquisition, and clinical results that have been obtained using these models.
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Affiliation(s)
- Anupama Ramachandran
- Brigham and Women's Hospital, Harvard University, Boston, MA, USA; Department of Radiology, University of Michigan, AnnArbor, MI, USA
| | - Hero Hussain
- Department of Radiology, University of Michigan, AnnArbor, MI, USA
| | | | - Vikas Gulani
- Department of Radiology, University of Michigan, AnnArbor, MI, USA.
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12
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Zhou M, Huang H, Fan Y, Chen M, Li M, Wang Y. The application of quantitative perfusion analysis of golden-angle radial sparse parallel MRI and R2∗ value for predicting pathological prognostic factors in rectal cancer. Clin Radiol 2024; 79:124-132. [PMID: 38030505 DOI: 10.1016/j.crad.2023.10.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/25/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023]
Abstract
AIM To investigate the diagnostic value of golden-angle radial sparse parallel magnetic resonance imaging (MRI) (GRASP) and R2∗ in predicting the prognostic factors of resectable rectal cancer. MATERIALS AND METHODS A total of 108 patients with rectal adenocarcinoma were included in this retrospective study. The volume transfer constant (Ktrans), rate constant (Kep), plasma volume fraction (Ve), and R2∗ were obtained. Univariate and multivariate logistic regression were conducted. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic performance of the imaging parameters. RESULTS The Ktrans was found to be significantly higher in rectal cancers with positive lymph node metastasis (LNM), higher tumour grade, positive lymphovascular invasion (LVI), and higher ki-67 (all p<0.05). The Kep was also significantly higher in the LNM-positive group (p<0.001), while the R2∗ was higher in rectal cancers with LNM-positive, higher tumour grade, LVI-positive, and higher ki-67 (all p<0.05). Combining the Ktrans and R2∗ provided the highest area under the ROC curve (AUC) for LNM-positive and higher ki-67 tumours differentiation (0.790 and 0.823, respectively). DISCUSSION Combining quantitative parameters of the Ktrans and R2∗ could be used to non-invasively predict pathological prognostic factors preoperatively.
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Affiliation(s)
- M Zhou
- Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - H Huang
- Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Y Fan
- Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - M Chen
- Department of MR Scientific Marketing, Siemens Healthineers, Shanghai, 200135, China
| | - M Li
- Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Y Wang
- Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China.
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13
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Hindel S. A Generalized Kinetic Model of Fractional Order Transport Dynamics with Transit Time Heterogeneity in Microvascular Space. Bull Math Biol 2024; 86:26. [PMID: 38300429 DOI: 10.1007/s11538-023-01255-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 12/30/2023] [Indexed: 02/02/2024]
Abstract
The aim of this study is to develop and validate a unifying kinetic model for microvascular transport by introducing an impulse response function that incorporates essential physiological parameters and integrates key features of existing models. This new methodology combines a one-compartment model of fractional order with a model that uses the gamma distribution to describe the distribution of capillary transit times. Central to this model are two primary parameters: [Formula: see text], representing the kurtosis of residue times, and [Formula: see text], signifying the width of the distribution of capillary transit times within a tissue voxel. To validate this proposed model, data from dynamic contrast-enhanced magnetic resonance imaging (DCI-MRI) were employed and the findings were compared with three existing models. Using the Akaike information criterion for model selection, the results demonstrate that the integrative model, especially at elevated blood flow rates, frequently offers superior fits in comparison to constrained models.
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Affiliation(s)
- Stefan Hindel
- Department of Radiation Therapy, Medical Physics Division, University Hospital Essen, Essen, North Rhine-Westphalia, Germany.
- Faculty of Physics, Technische Universität Kaiserslautern, Kaiserslautern, Rhineland-Palatinate, Germany.
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14
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Kalisvaart GM, Van Den Berghe T, Grootjans W, Lejoly M, Huysse WCJ, Bovée JVMG, Creytens D, Gelderblom H, Speetjens FM, Lapeire L, van de Sande MAJ, Sys G, de Geus-Oei LF, Verstraete KL, Bloem JL. Evaluation of response to neoadjuvant chemotherapy in osteosarcoma using dynamic contrast-enhanced MRI: development and external validation of a model. Skeletal Radiol 2024; 53:319-328. [PMID: 37464020 PMCID: PMC10730632 DOI: 10.1007/s00256-023-04402-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/03/2023] [Accepted: 07/04/2023] [Indexed: 07/20/2023]
Abstract
OBJECTIVE To identify which dynamic contrast-enhanced (DCE-)MRI features best predict histological response to neoadjuvant chemotherapy in patients with an osteosarcoma. METHODS Patients with osteosarcoma who underwent DCE-MRI before and after neoadjuvant chemotherapy prior to resection were retrospectively included at two different centers. Data from the center with the larger cohort (training cohort) was used to identify which method for region-of-interest selection (whole slab or focal area method) and which change in DCE-MRI features (time to enhancement, wash-in rate, maximum relative enhancement and area under the curve) gave the most accurate prediction of histological response. Models were created using logistic regression and cross-validated. The most accurate model was then externally validated using data from the other center (test cohort). RESULTS Fifty-five (27 poor response) and 30 (19 poor response) patients were included in training and test cohorts, respectively. Intraclass correlation coefficient of relative DCE-MRI features ranged 0.81-0.97 with the whole slab and 0.57-0.85 with the focal area segmentation method. Poor histological response was best predicted with the whole slab segmentation method using a single feature threshold, relative wash-in rate <2.3. Mean accuracy was 0.85 (95%CI: 0.75-0.95), and area under the receiver operating characteristic curve (AUC-index) was 0.93 (95%CI: 0.86-1.00). In external validation, accuracy and AUC-index were 0.80 and 0.80. CONCLUSION In this study, a relative wash-in rate of <2.3 determined with the whole slab segmentation method predicted histological response to neoadjuvant chemotherapy in osteosarcoma. Consistent performance was observed in an external test cohort.
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Affiliation(s)
- Gijsbert M Kalisvaart
- Department of Radiology and Nuclear Medicine, Leiden University Medical Center, Albinusdreef 2, 2333, ZA, Leiden, The Netherlands.
| | - Thomas Van Den Berghe
- Department of Radiology and Medical Imaging, Ghent University Hospital, Ghent, Belgium
| | - Willem Grootjans
- Department of Radiology and Nuclear Medicine, Leiden University Medical Center, Albinusdreef 2, 2333, ZA, Leiden, The Netherlands
| | - Maryse Lejoly
- Department of Radiology and Medical Imaging, Ghent University Hospital, Ghent, Belgium
| | - Wouter C J Huysse
- Department of Radiology and Medical Imaging, Ghent University Hospital, Ghent, Belgium
| | - Judith V M G Bovée
- Department of Pathology, Leiden University Medical Center, Albinusdreef 2, 2333, ZA, Leiden, The Netherlands
| | - David Creytens
- Department of Pathology, Ghent University Hospital, Ghent, Belgium
| | - Hans Gelderblom
- Department of Medical Oncology, Leiden University Medical Center, Albinusdreef 2, 2333, ZA, Leiden, The Netherlands
| | - Frank M Speetjens
- Department of Medical Oncology, Leiden University Medical Center, Albinusdreef 2, 2333, ZA, Leiden, The Netherlands
| | - Lore Lapeire
- Department of Medical Oncology, Ghent University Hospital, Ghent, Belgium
| | - Michiel A J van de Sande
- Department of Orthopedics, Leiden University Medical Center, Albinusdreef 2, 2333, ZA, Leiden, The Netherlands
| | - Gwen Sys
- Department of Orthopedics, Ghent University Hospital, Ghent, Belgium
| | - Lioe-Fee de Geus-Oei
- Department of Radiology and Nuclear Medicine, Leiden University Medical Center, Albinusdreef 2, 2333, ZA, Leiden, The Netherlands
| | - Koenraad L Verstraete
- Department of Radiology and Medical Imaging, Ghent University Hospital, Ghent, Belgium
| | - Johan L Bloem
- Department of Radiology and Nuclear Medicine, Leiden University Medical Center, Albinusdreef 2, 2333, ZA, Leiden, The Netherlands
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15
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Griffith JF, Yip SWY, van der Heijden RA, Valenzuela RF, Yeung DKW. Perfusion Imaging of the Musculoskeletal System. Magn Reson Imaging Clin N Am 2024; 32:181-206. [PMID: 38007280 DOI: 10.1016/j.mric.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2023]
Abstract
Perfusion imaging is the aspect of functional imaging, which is most applicable to the musculoskeletal system. In this review, the anatomy and physiology of bone perfusion is briefly outlined as are the methods of acquiring perfusion data on MR imaging. The current clinical indications of perfusion related to the assessment of soft tissue and bone tumors, synovitis, osteoarthritis, avascular necrosis, Keinbock's disease, diabetic foot, osteochondritis dissecans, and Paget's disease of bone are reviewed. Challenges and opportunities related to perfusion imaging of the musculoskeletal system are also briefly addressed.
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Affiliation(s)
- James F Griffith
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong.
| | - Stefanie W Y Yip
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong
| | - Rianne A van der Heijden
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Radiology, University of Wisconsin-Madison, Madison, WI, USA
| | - Raul F Valenzuela
- Department of Musculoskeletal Imaging, The University of Texas, MD Anderson Cancer Center, USA
| | - David K W Yeung
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong
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16
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Kataoka M, Iima M, Miyake KK, Honda M. Multiparametric Approach to Breast Cancer With Emphasis on Magnetic Resonance Imaging in the Era of Personalized Breast Cancer Treatment. Invest Radiol 2024; 59:26-37. [PMID: 37994113 DOI: 10.1097/rli.0000000000001044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
ABSTRACT A multiparametric approach to breast cancer imaging offers the advantage of integrating the diverse contributions of various parameters. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is the most important MRI sequence for breast imaging. The vascularity and permeability of lesions can be estimated through the use of semiquantitative and quantitative parameters. The increased use of ultrafast DCE-MRI has facilitated the introduction of novel kinetic parameters. In addition to DCE-MRI, diffusion-weighted imaging provides information associated with tumor cell density, with advanced diffusion-weighted imaging techniques such as intravoxel incoherent motion, diffusion kurtosis imaging, and time-dependent diffusion MRI opening up new horizons in microscale tissue evaluation. Furthermore, T2-weighted imaging plays a key role in measuring the degree of tumor aggressiveness, which may be related to the tumor microenvironment. Magnetic resonance imaging is, however, not the only imaging modality providing semiquantitative and quantitative parameters from breast tumors. Breast positron emission tomography demonstrates superior spatial resolution to whole-body positron emission tomography and allows comparable delineation of breast cancer to MRI, as well as providing metabolic information, which often precedes vascular and morphological changes occurring in response to treatment. The integration of these imaging-derived factors is accomplished through multiparametric imaging. In this article, we explore the relationship among the key imaging parameters, breast cancer diagnosis, and histological characteristics, providing a technical and theoretical background for these parameters. Furthermore, we review the recent studies on the application of multiparametric imaging to breast cancer and the significance of the key imaging parameters.
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Affiliation(s)
- Masako Kataoka
- From the Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine Kyoto University, Kyoto, Japan (M.K., M.I., M.H.); Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital, Kyoto, Japan (M.I.); Department of Advanced Imaging in Medical Magnetic Resonance, Graduate School of Medicine Kyoto University, Kyoto, Japan (K.K.M); and Department of Diagnostic Radiology, Kansai Electric Power Hospital, Osaka, Japan (M.H.)
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17
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Kåstad Høiskar M, Sæther O, Delange Alsaker M, Røe Redalen K, Winter RM. Quantitative dynamic contrast-enhanced magnetic resonance imaging in head and neck cancer: A systematic comparison of different modelling approaches. Phys Imaging Radiat Oncol 2024; 29:100548. [PMID: 38380153 PMCID: PMC10876686 DOI: 10.1016/j.phro.2024.100548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 01/24/2024] [Accepted: 02/05/2024] [Indexed: 02/22/2024] Open
Abstract
Background and purpose Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) describes tissue microvasculature and has prognostic and predictive potential in radiotherapy for head and neck cancer (HNC). However, lack in standardization of DCE-MRI hinders comparison of studies and clinical implementation. This study investigated the accuracy and robustness of the population arterial input function (AIF), correlations between pharmacokinetic parameters and their association to T stage and human papillomavirus (HPV) status for HNC. Materials and methods DCE-MRI was acquired for 44 HNC patients. Population AIFs were calculated with six different approaches. DCE-MRI was analysed in primary and lymph node tumours using Tofts model (TM) with population AIFs and individual AIFs, extended TM (ETM) with individual AIFs, Brix model (BM), and areas under the curve (AUCs). Intraclass correlation, concordance correlation, Pearson correlation and Whitney Mann U test helped examining the robustness and accuracy of population AIF, correlations between DCE-MRI parameters and their association to T stage and HPV status, respectively. Results The population AIF was robust but differed from individual AIFs. There was significant correlation between KtransTM/ETM and ve, TM/ETM, and KtransTM/ETM and Kep, TM/ETM. ABrix and AUCs correlated for lymph nodes. Kep, Brix correlated with ABrix, KtransTM/ETM and Kep, TM/ETM for primary tumours. Kep, TM significantly decreased with increasing T stage. Both the correlations and the parameters' association to T stage were stronger for HPV negative lesions. Conclusions Individual AIF was preferred for accurate pharmacokinetic modelling of DCE-MRI. DCE-MRI parameters and their correlations were affected by the lesion type, HPV status and T staging.
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Affiliation(s)
- Marte Kåstad Høiskar
- Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway
| | - Oddbjørn Sæther
- Department of Radiology and Nuclear Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | | | - Kathrine Røe Redalen
- Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway
| | - René M. Winter
- Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway
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18
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Mooshage CM, Tsilingiris D, Schimpfle L, Kender Z, Aziz-Safaie T, Hohmann A, Szendroedi J, Nawroth P, Sturm V, Heiland S, Bendszus M, Kopf S, Kurz FT, Jende JME. Insulin Resistance Is Associated With Reduced Capillary Permeability of Thigh Muscles in Patients With Type 2 Diabetes. J Clin Endocrinol Metab 2023; 109:e137-e144. [PMID: 37579325 DOI: 10.1210/clinem/dgad481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/08/2023] [Accepted: 08/11/2023] [Indexed: 08/16/2023]
Abstract
CONTEXT Insulin-mediated microvascular permeability and blood flow of skeletal muscle appears to be altered in the condition of insulin resistance. Previous studies on this effect used invasive procedures in humans or animals. OBJECTIVE The aim of this study was to demonstrate the feasibility of a noninvasive assessment of human muscle microcirculation via dynamic contrast-enhanced (DCE)-magnetic resonance imaging (MRI) of skeletal muscle in patients with type 2 diabetes (T2D). METHODS A total of 56 participants (46 with T2D, 10 healthy controls [HC]) underwent DCE-MRI of the right thigh at 3 Tesla. The constant of the musculature's microvascular permeability (Ktrans), extravascular extracellular volume fraction (ve), and plasma volume fraction (vp) were calculated. RESULTS In T2D patients, skeletal muscle Ktrans was lower (HC 0.0677 ± 0.002 min-1, T2D 0.0664 ± 0.002 min-1; P = 0.042) while the homeostasis model assessment (HOMA) index was higher in patients with T2D compared to HC (HC 2.72 ± 2.2, T2D 6.11 ± 6.2; P = .011). In T2D, Ktrans correlated negatively with insulin (r = -0.39, P = .018) and HOMA index (r = -0.38, P = .020). CONCLUSION The results signify that skeletal muscle DCE-MRI can be employed as a noninvasive technique for the assessment of muscle microcirculation in T2D. Our findings suggest that microvascular permeability of skeletal muscle is lowered in patients with T2D and that a decrease in microvascular permeability is associated with insulin resistance. These results are of interest with regard to the impact of muscle perfusion on diabetic complications such as diabetic sarcopenia.
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Affiliation(s)
- Christoph M Mooshage
- Department of Neuroradiology, Heidelberg University Hospital, 69120 Heidelberg, Germany
| | - Dimitrios Tsilingiris
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, 69120 Heidelberg, Germany
- German Center for Diabetes Research, DZD, 85764 München-Neuherberg, Germany
| | - Lukas Schimpfle
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, 69120 Heidelberg, Germany
- German Center for Diabetes Research, DZD, 85764 München-Neuherberg, Germany
- Institute for Diabetes and Cancer (IDC), Helmholtz Diabetes Center, Helmholtz Center, Munich, 85764 Neuherberg, Germany
| | - Zoltan Kender
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, 69120 Heidelberg, Germany
- German Center for Diabetes Research, DZD, 85764 München-Neuherberg, Germany
- Institute for Diabetes and Cancer (IDC), Helmholtz Diabetes Center, Helmholtz Center, Munich, 85764 Neuherberg, Germany
| | - Taraneh Aziz-Safaie
- Department of Neuroradiology, Heidelberg University Hospital, 69120 Heidelberg, Germany
| | - Anja Hohmann
- Department of Neurology, Heidelberg University Hospital, 69120 Heidelberg, Germany
| | - Julia Szendroedi
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, 69120 Heidelberg, Germany
- German Center for Diabetes Research, DZD, 85764 München-Neuherberg, Germany
- Joint Heidelberg-IDC Translational Diabetes Program, Inner Medicine 1, Heidelberg University Hospital, 69120 Heidelberg, Germany
| | - Peter Nawroth
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, 69120 Heidelberg, Germany
- German Center for Diabetes Research, DZD, 85764 München-Neuherberg, Germany
- Joint Heidelberg-IDC Translational Diabetes Program, Inner Medicine 1, Heidelberg University Hospital, 69120 Heidelberg, Germany
| | - Volker Sturm
- Department of Neuroradiology, Heidelberg University Hospital, 69120 Heidelberg, Germany
- Division of Experimental Radiology, Department of Neuroradiology, Heidelberg University Hospital, 69120 Heidelberg, Germany
| | - Sabine Heiland
- Department of Neuroradiology, Heidelberg University Hospital, 69120 Heidelberg, Germany
- Division of Experimental Radiology, Department of Neuroradiology, Heidelberg University Hospital, 69120 Heidelberg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, Heidelberg University Hospital, 69120 Heidelberg, Germany
| | - Stefan Kopf
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, 69120 Heidelberg, Germany
- German Center for Diabetes Research, DZD, 85764 München-Neuherberg, Germany
- Institute for Diabetes and Cancer (IDC), Helmholtz Diabetes Center, Helmholtz Center, Munich, 85764 Neuherberg, Germany
| | - Felix T Kurz
- Department of Neuroradiology, Heidelberg University Hospital, 69120 Heidelberg, Germany
- Department of Radiology, German Cancer Research Center, 69120 Heidelberg, Germany
| | - Johann M E Jende
- Department of Neuroradiology, Heidelberg University Hospital, 69120 Heidelberg, Germany
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LoCastro E, Paudyal R, Konar AS, LaViolette PS, Akin O, Hatzoglou V, Goh AC, Bochner BH, Rosenberg J, Wong RJ, Lee NY, Schwartz LH, Shukla-Dave A. A Quantitative Multiparametric MRI Analysis Platform for Estimation of Robust Imaging Biomarkers in Clinical Oncology. Tomography 2023; 9:2052-2066. [PMID: 37987347 PMCID: PMC10661267 DOI: 10.3390/tomography9060161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/12/2023] [Accepted: 10/18/2023] [Indexed: 11/22/2023] Open
Abstract
There is a need to develop user-friendly imaging tools estimating robust quantitative biomarkers (QIBs) from multiparametric (mp)MRI for clinical applications in oncology. Quantitative metrics derived from (mp)MRI can monitor and predict early responses to treatment, often prior to anatomical changes. We have developed a vendor-agnostic, flexible, and user-friendly MATLAB-based toolkit, MRI-Quantitative Analysis and Multiparametric Evaluation Routines ("MRI-QAMPER", current release v3.0), for the estimation of quantitative metrics from dynamic contrast-enhanced (DCE) and multi-b value diffusion-weighted (DW) MR and MR relaxometry. MRI-QAMPER's functionality includes generating numerical parametric maps from these methods reflecting tumor permeability, cellularity, and tissue morphology. MRI-QAMPER routines were validated using digital reference objects (DROs) for DCE and DW MRI, serving as initial approval stages in the National Cancer Institute Quantitative Imaging Network (NCI/QIN) software benchmark. MRI-QAMPER has participated in DCE and DW MRI Collaborative Challenge Projects (CCPs), which are key technical stages in the NCI/QIN benchmark. In a DCE CCP, QAMPER presented the best repeatability coefficient (RC = 0.56) across test-retest brain metastasis data, out of ten participating DCE software packages. In a DW CCP, QAMPER ranked among the top five (out of fourteen) tools with the highest area under the curve (AUC) for prostate cancer detection. This platform can seamlessly process mpMRI data from brain, head and neck, thyroid, prostate, pancreas, and bladder cancer. MRI-QAMPER prospectively analyzes dose de-escalation trial data for oropharyngeal cancer, which has earned it advanced NCI/QIN approval for expanded usage and applications in wider clinical trials.
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Affiliation(s)
- Eve LoCastro
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (E.L.); (R.P.); (A.S.K.)
| | - Ramesh Paudyal
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (E.L.); (R.P.); (A.S.K.)
| | - Amaresha Shridhar Konar
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (E.L.); (R.P.); (A.S.K.)
| | - Peter S. LaViolette
- Department of Radiology, Medical College of Wisconsin, Milwaukee, WI 53226, USA;
| | - Oguz Akin
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (O.A.); (V.H.); (L.H.S.)
| | - Vaios Hatzoglou
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (O.A.); (V.H.); (L.H.S.)
| | - Alvin C. Goh
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (A.C.G.); (B.H.B.); (R.J.W.)
| | - Bernard H. Bochner
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (A.C.G.); (B.H.B.); (R.J.W.)
| | - Jonathan Rosenberg
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA;
| | - Richard J. Wong
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (A.C.G.); (B.H.B.); (R.J.W.)
| | - Nancy Y. Lee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA;
| | - Lawrence H. Schwartz
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (O.A.); (V.H.); (L.H.S.)
| | - Amita Shukla-Dave
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (E.L.); (R.P.); (A.S.K.)
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (O.A.); (V.H.); (L.H.S.)
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20
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Zhong J, Kobus M, Maitre P, Datta A, Eccles C, Dubec M, McHugh D, Buckley D, Scarsbrook A, Hoskin P, Henry A, Choudhury A. MRI-guided Pelvic Radiation Therapy: A Primer for Radiologists. Radiographics 2023; 43:e230052. [PMID: 37796729 DOI: 10.1148/rg.230052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
Radiation therapy (RT) is a core pillar of oncologic treatment, and half of all patients with cancer receive this therapy as a curative or palliative treatment. The recent integration of MRI into the RT workflow has led to the advent of MRI-guided RT (MRIgRT). Using MRI rather than CT has clear advantages for guiding RT to pelvic tumors, including superior soft-tissue contrast, improved organ motion visualization, and the potential to image tumor phenotypic characteristics to identify the most aggressive or treatment-resistant areas, which can be targeted with a more focal higher radiation dose. Radiologists should be familiar with the potential uses of MRI in planning pelvic RT; the various RT techniques used, such as brachytherapy and external beam RT; and the impact of MRIgRT on treatment paradigms. Current clinical experience with and the evidence base for MRIgRT in the settings of prostate, cervical, and bladder cancer are discussed, and examples of treated cases are illustrated. In addition, the benefits of MRIgRT, such as real-time online adaptation of RT (during treatment) and interfraction and/or intrafraction adaptation to organ motion, as well as how MRIgRT can decrease toxic effects and improve oncologic outcomes, are highlighted. MRIgRT is particularly beneficial for treating mobile pelvic structures, and real-time adaptive RT for tumors can be achieved by using advanced MRI-guided linear accelerator systems to spare organs at risk. Future opportunities for development of biologically driven adapted RT with use of functional MRI sequences and radiogenomic approaches also are outlined. ©RSNA, 2023 Quiz questions for this article are available in the supplemental material.
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Affiliation(s)
- Jim Zhong
- From the Leeds Institute of Medical Research (J.Z., A.S., A.H.) and Department of Biomedical Imaging (D.B.), University of Leeds, 6 Clarendon Way, Woodhouse, Leeds LS2 9LH, England; Leeds Cancer Centre, St James's University Hospital, Leeds, England (J.Z., A.S., A.H.); Department of Radiation Oncology, Charité Universitätsmedizin Berlin, Berlin, Germany (M.K.); Radiation Therapy Research Group (M.K., P.M., A.D., C.E., M.D., P.H., A.C.) and Division of Cancer Sciences (D.M.), University of Manchester, Manchester, England; and The Christie NHS Foundation Trust, Manchester, England (P.M., C.E., M.D., D.M., P.H., A.C.)
| | - Marta Kobus
- From the Leeds Institute of Medical Research (J.Z., A.S., A.H.) and Department of Biomedical Imaging (D.B.), University of Leeds, 6 Clarendon Way, Woodhouse, Leeds LS2 9LH, England; Leeds Cancer Centre, St James's University Hospital, Leeds, England (J.Z., A.S., A.H.); Department of Radiation Oncology, Charité Universitätsmedizin Berlin, Berlin, Germany (M.K.); Radiation Therapy Research Group (M.K., P.M., A.D., C.E., M.D., P.H., A.C.) and Division of Cancer Sciences (D.M.), University of Manchester, Manchester, England; and The Christie NHS Foundation Trust, Manchester, England (P.M., C.E., M.D., D.M., P.H., A.C.)
| | - Priyamvada Maitre
- From the Leeds Institute of Medical Research (J.Z., A.S., A.H.) and Department of Biomedical Imaging (D.B.), University of Leeds, 6 Clarendon Way, Woodhouse, Leeds LS2 9LH, England; Leeds Cancer Centre, St James's University Hospital, Leeds, England (J.Z., A.S., A.H.); Department of Radiation Oncology, Charité Universitätsmedizin Berlin, Berlin, Germany (M.K.); Radiation Therapy Research Group (M.K., P.M., A.D., C.E., M.D., P.H., A.C.) and Division of Cancer Sciences (D.M.), University of Manchester, Manchester, England; and The Christie NHS Foundation Trust, Manchester, England (P.M., C.E., M.D., D.M., P.H., A.C.)
| | - Anubhav Datta
- From the Leeds Institute of Medical Research (J.Z., A.S., A.H.) and Department of Biomedical Imaging (D.B.), University of Leeds, 6 Clarendon Way, Woodhouse, Leeds LS2 9LH, England; Leeds Cancer Centre, St James's University Hospital, Leeds, England (J.Z., A.S., A.H.); Department of Radiation Oncology, Charité Universitätsmedizin Berlin, Berlin, Germany (M.K.); Radiation Therapy Research Group (M.K., P.M., A.D., C.E., M.D., P.H., A.C.) and Division of Cancer Sciences (D.M.), University of Manchester, Manchester, England; and The Christie NHS Foundation Trust, Manchester, England (P.M., C.E., M.D., D.M., P.H., A.C.)
| | - Cynthia Eccles
- From the Leeds Institute of Medical Research (J.Z., A.S., A.H.) and Department of Biomedical Imaging (D.B.), University of Leeds, 6 Clarendon Way, Woodhouse, Leeds LS2 9LH, England; Leeds Cancer Centre, St James's University Hospital, Leeds, England (J.Z., A.S., A.H.); Department of Radiation Oncology, Charité Universitätsmedizin Berlin, Berlin, Germany (M.K.); Radiation Therapy Research Group (M.K., P.M., A.D., C.E., M.D., P.H., A.C.) and Division of Cancer Sciences (D.M.), University of Manchester, Manchester, England; and The Christie NHS Foundation Trust, Manchester, England (P.M., C.E., M.D., D.M., P.H., A.C.)
| | - Michael Dubec
- From the Leeds Institute of Medical Research (J.Z., A.S., A.H.) and Department of Biomedical Imaging (D.B.), University of Leeds, 6 Clarendon Way, Woodhouse, Leeds LS2 9LH, England; Leeds Cancer Centre, St James's University Hospital, Leeds, England (J.Z., A.S., A.H.); Department of Radiation Oncology, Charité Universitätsmedizin Berlin, Berlin, Germany (M.K.); Radiation Therapy Research Group (M.K., P.M., A.D., C.E., M.D., P.H., A.C.) and Division of Cancer Sciences (D.M.), University of Manchester, Manchester, England; and The Christie NHS Foundation Trust, Manchester, England (P.M., C.E., M.D., D.M., P.H., A.C.)
| | - Damien McHugh
- From the Leeds Institute of Medical Research (J.Z., A.S., A.H.) and Department of Biomedical Imaging (D.B.), University of Leeds, 6 Clarendon Way, Woodhouse, Leeds LS2 9LH, England; Leeds Cancer Centre, St James's University Hospital, Leeds, England (J.Z., A.S., A.H.); Department of Radiation Oncology, Charité Universitätsmedizin Berlin, Berlin, Germany (M.K.); Radiation Therapy Research Group (M.K., P.M., A.D., C.E., M.D., P.H., A.C.) and Division of Cancer Sciences (D.M.), University of Manchester, Manchester, England; and The Christie NHS Foundation Trust, Manchester, England (P.M., C.E., M.D., D.M., P.H., A.C.)
| | - David Buckley
- From the Leeds Institute of Medical Research (J.Z., A.S., A.H.) and Department of Biomedical Imaging (D.B.), University of Leeds, 6 Clarendon Way, Woodhouse, Leeds LS2 9LH, England; Leeds Cancer Centre, St James's University Hospital, Leeds, England (J.Z., A.S., A.H.); Department of Radiation Oncology, Charité Universitätsmedizin Berlin, Berlin, Germany (M.K.); Radiation Therapy Research Group (M.K., P.M., A.D., C.E., M.D., P.H., A.C.) and Division of Cancer Sciences (D.M.), University of Manchester, Manchester, England; and The Christie NHS Foundation Trust, Manchester, England (P.M., C.E., M.D., D.M., P.H., A.C.)
| | - Andrew Scarsbrook
- From the Leeds Institute of Medical Research (J.Z., A.S., A.H.) and Department of Biomedical Imaging (D.B.), University of Leeds, 6 Clarendon Way, Woodhouse, Leeds LS2 9LH, England; Leeds Cancer Centre, St James's University Hospital, Leeds, England (J.Z., A.S., A.H.); Department of Radiation Oncology, Charité Universitätsmedizin Berlin, Berlin, Germany (M.K.); Radiation Therapy Research Group (M.K., P.M., A.D., C.E., M.D., P.H., A.C.) and Division of Cancer Sciences (D.M.), University of Manchester, Manchester, England; and The Christie NHS Foundation Trust, Manchester, England (P.M., C.E., M.D., D.M., P.H., A.C.)
| | - Peter Hoskin
- From the Leeds Institute of Medical Research (J.Z., A.S., A.H.) and Department of Biomedical Imaging (D.B.), University of Leeds, 6 Clarendon Way, Woodhouse, Leeds LS2 9LH, England; Leeds Cancer Centre, St James's University Hospital, Leeds, England (J.Z., A.S., A.H.); Department of Radiation Oncology, Charité Universitätsmedizin Berlin, Berlin, Germany (M.K.); Radiation Therapy Research Group (M.K., P.M., A.D., C.E., M.D., P.H., A.C.) and Division of Cancer Sciences (D.M.), University of Manchester, Manchester, England; and The Christie NHS Foundation Trust, Manchester, England (P.M., C.E., M.D., D.M., P.H., A.C.)
| | - Ann Henry
- From the Leeds Institute of Medical Research (J.Z., A.S., A.H.) and Department of Biomedical Imaging (D.B.), University of Leeds, 6 Clarendon Way, Woodhouse, Leeds LS2 9LH, England; Leeds Cancer Centre, St James's University Hospital, Leeds, England (J.Z., A.S., A.H.); Department of Radiation Oncology, Charité Universitätsmedizin Berlin, Berlin, Germany (M.K.); Radiation Therapy Research Group (M.K., P.M., A.D., C.E., M.D., P.H., A.C.) and Division of Cancer Sciences (D.M.), University of Manchester, Manchester, England; and The Christie NHS Foundation Trust, Manchester, England (P.M., C.E., M.D., D.M., P.H., A.C.)
| | - Ananya Choudhury
- From the Leeds Institute of Medical Research (J.Z., A.S., A.H.) and Department of Biomedical Imaging (D.B.), University of Leeds, 6 Clarendon Way, Woodhouse, Leeds LS2 9LH, England; Leeds Cancer Centre, St James's University Hospital, Leeds, England (J.Z., A.S., A.H.); Department of Radiation Oncology, Charité Universitätsmedizin Berlin, Berlin, Germany (M.K.); Radiation Therapy Research Group (M.K., P.M., A.D., C.E., M.D., P.H., A.C.) and Division of Cancer Sciences (D.M.), University of Manchester, Manchester, England; and The Christie NHS Foundation Trust, Manchester, England (P.M., C.E., M.D., D.M., P.H., A.C.)
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21
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Dejene EM, Brenner W, Makowski MR, Kolbitsch C. Unified Bayesian network for uncertainty quantification of physiological parameters in dynamic contrast enhanced (DCE) MRI of the liver. Phys Med Biol 2023; 68:215018. [PMID: 37820640 DOI: 10.1088/1361-6560/ad0284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 10/11/2023] [Indexed: 10/13/2023]
Abstract
Objective. Physiological parameter estimation is affected by intrinsic ambiguity in the data such as noise and model inaccuracies. The aim of this work is to provide a deep learning framework for accurate parameter and uncertainty estimates for DCE-MRI in the liver.Approach. Concentration time curves are simulated to train a Bayesian neural network (BNN). Training of the BNN involves minimization of a loss function that jointly minimizes the aleatoric and epistemic uncertainties. Uncertainty estimation is evaluated for different noise levels and for different out of distribution (OD) cases, i.e. where the data during inference differs strongly to the data during training. The accuracy of parameter estimates are compared to a nonlinear least squares (NLLS) fitting in numerical simulations andin vivodata of a patient suffering from hepatic tumor lesions.Main results. BNN achieved lower root-mean-squared-errors (RMSE) than the NLLS for the simulated data. RMSE of BNN was on overage of all noise levels lower by 33% ± 1.9% forktrans, 22% ± 6% forveand 89% ± 5% forvpthan the NLLS. The aleatoric uncertainties of the parameters increased with increasing noise level, whereas the epistemic uncertainty increased when a BNN was evaluated with OD data. For thein vivodata, more robust parameter estimations were obtained by the BNN than the NLLS fit. In addition, the differences between estimated parameters for healthy and tumor regions-of-interest were significant (p< 0.0001).Significance. The proposed framework allowed for accurate parameter estimates for quantitative DCE-MRI. In addition, the BNN provided uncertainty estimates which highlighted cases of high noise and in which the training data did not match the data during inference. This is important for clinical application because it would indicate cases in which the trained model is inadequate and additional training with an adapted training data set is required.
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Affiliation(s)
- Edengenet M Dejene
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany
- Department of Radiology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Winfried Brenner
- Department of Nuclear Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Marcus R Makowski
- Department of Radiology, Charité Universitätsmedizin Berlin, Berlin, Germany
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Technical University of Munich, Munich, Germany
| | - Christoph Kolbitsch
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany
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22
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van der Hulst HJ, Jansen RW, Vens C, Bos P, Schats W, de Jong MC, Martens RM, Bodalal Z, Beets-Tan RGH, van den Brekel MWM, de Graaf P, Castelijns JA. The Prediction of Biological Features Using Magnetic Resonance Imaging in Head and Neck Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis. Cancers (Basel) 2023; 15:5077. [PMID: 37894447 PMCID: PMC10605807 DOI: 10.3390/cancers15205077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/13/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023] Open
Abstract
Magnetic resonance imaging (MRI) is an indispensable, routine technique that provides morphological and functional imaging sequences. MRI can potentially capture tumor biology and allow for longitudinal evaluation of head and neck squamous cell carcinoma (HNSCC). This systematic review and meta-analysis evaluates the ability of MRI to predict tumor biology in primary HNSCC. Studies were screened, selected, and assessed for quality using appropriate tools according to the PRISMA criteria. Fifty-eight articles were analyzed, examining the relationship between (functional) MRI parameters and biological features and genetics. Most studies focused on HPV status associations, revealing that HPV-positive tumors consistently exhibited lower ADCmean (SMD: 0.82; p < 0.001) and ADCminimum (SMD: 0.56; p < 0.001) values. On average, lower ADCmean values are associated with high Ki-67 levels, linking this diffusion restriction to high cellularity. Several perfusion parameters of the vascular compartment were significantly associated with HIF-1α. Analysis of other biological factors (VEGF, EGFR, tumor cell count, p53, and MVD) yielded inconclusive results. Larger datasets with homogenous acquisition are required to develop and test radiomic-based prediction models capable of capturing different aspects of the underlying tumor biology. Overall, our study shows that rapid and non-invasive characterization of tumor biology via MRI is feasible and could enhance clinical outcome predictions and personalized patient management for HNSCC.
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Affiliation(s)
- Hedda J. van der Hulst
- Department of Radiology, The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
- GROW School for Oncology and Developmental Biology, University of Maastricht, 6211 LK Maastricht, The Netherlands
| | - Robin W. Jansen
- Department of Otolaryngology and Head & Neck Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, 1081 HZ Amsterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Location Vrije Universiteit Amsterdam, 1081 HZ Amsterdam, The Netherlands
- Cancer Center Amsterdam, Imaging and Biomarkers, 1081 HV Amsterdam, The Netherlands
| | - Conchita Vens
- Department of Otolaryngology and Head & Neck Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, 1081 HZ Amsterdam, The Netherlands
- School of Cancer Science, University of Glasgow, Glasgow G61 1QH, UK
| | - Paula Bos
- Department of Radiation Oncology, The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
| | - Winnie Schats
- Scientific Information Service, The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
| | - Marcus C. de Jong
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Location Vrije Universiteit Amsterdam, 1081 HZ Amsterdam, The Netherlands
- Cancer Center Amsterdam, Imaging and Biomarkers, 1081 HV Amsterdam, The Netherlands
| | - Roland M. Martens
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Location Vrije Universiteit Amsterdam, 1081 HZ Amsterdam, The Netherlands
- Cancer Center Amsterdam, Imaging and Biomarkers, 1081 HV Amsterdam, The Netherlands
| | - Zuhir Bodalal
- Department of Radiology, The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
- GROW School for Oncology and Developmental Biology, University of Maastricht, 6211 LK Maastricht, The Netherlands
| | - Regina G. H. Beets-Tan
- Department of Radiology, The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
- GROW School for Oncology and Developmental Biology, University of Maastricht, 6211 LK Maastricht, The Netherlands
- Department of Regional Health Research, University of Southern Denmark, 5230 Odense, Denmark
| | - Michiel W. M. van den Brekel
- Department of Otolaryngology and Head & Neck Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, 1081 HZ Amsterdam, The Netherlands
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
- Department of Otolaryngology and Head & Neck Surgery, Amsterdam UMC Location University of Amsterdam, 1081 HZ Amsterdam, The Netherlands
| | - Pim de Graaf
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Location Vrije Universiteit Amsterdam, 1081 HZ Amsterdam, The Netherlands
- Cancer Center Amsterdam, Imaging and Biomarkers, 1081 HV Amsterdam, The Netherlands
| | - Jonas A. Castelijns
- Department of Radiology, The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
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23
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Zhou A, Leach JR, Zhu C, Dong H, Jiang F, Lee YJ, Iannuzzi J, Gasper W, Saloner D, Hope MD, Mitsouras D. Dynamic Contrast-Enhanced MRI in Abdominal Aortic Aneurysms as a Potential Marker for Disease Progression. J Magn Reson Imaging 2023; 58:1258-1267. [PMID: 36747321 DOI: 10.1002/jmri.28640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 01/24/2023] [Accepted: 01/26/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Abdominal aortic aneurysms (AAAs) may rupture before reaching maximum diameter (Dmax ) thresholds for repair. Aortic wall microvasculature has been associated with elastin content and rupture sites in specimens, but its relation to progression is unknown. PURPOSE To investigate whether dynamic contrast-enhanced (DCE) MRI of AAA is associated with Dmax or growth. STUDY TYPE Prospective. POPULATION A total of 27 male patients with infrarenal AAA (mean age ± standard deviation = 75 ± 5 years) under surveillance with DCE MRI and 2 years of prior follow-up intervals with computed tomography (CT) or MRI. FIELD STRENGTH/SEQUENCE A 3-T, dynamic three-dimensional (3D) fast gradient-echo stack-of-stars volumetric interpolated breath-hold examination (Star-VIBE). ASSESSMENT Wall voxels were manually segmented in two consecutive slices at the level of Dmax . We measured slope to 1-minute and area under the curve (AUC) to 1 minute and 4 minutes of the signal intensity change postcontrast relative to that precontrast arrival, and, Ktrans , a measure of microvascular permeability, using the Patlak model. These were averaged over all wall voxels for association to Dmax and growth rate, and, over left/right and anterior/posterior quadrants for testing circumferential homogeneity. Dmax was measured orthogonal to the aortic centerline and growth rate was calculated by linear fit of Dmax measurements. STATISTICAL TESTS Pearson correlation and linear mixed effects models. A P value <0.05 was considered statistically significant. RESULTS In 44 DCE MRIs, mean Dmax was 45 ± 7 mm and growth rate in 1.5 ± 0.4 years of prior follow-up was 1.7 ± 1.2 mm per year. DCE measurements correlated with each other (Pearson r = 0.39-0.99) and significantly differed between anterior/posterior versus left/right quadrants. DCE measurements were not significantly associated with Dmax (P = 0.084, 0.289, 0.054 and 0.255 for slope, AUC at 1 minute and 4 minutes, and Ktrans , respectively). Slope and 4 minutes AUC significantly associated with growth rate after controlling for Dmax . CONCLUSION Contrast uptake may be increased in lateral aspects of the AAA. Contrast enhancement 1-minute slope and 4-minutes AUC may be associated with a period of recent AAA growth that is independent of Dmax . EVIDENCE LEVEL 3. TECHNICAL EFFICACY Stage 2.
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Affiliation(s)
- Ang Zhou
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
| | - Joseph R Leach
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
| | - Chengcheng Zhu
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Huiming Dong
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
| | - Fei Jiang
- Department of Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Yoo Jin Lee
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - James Iannuzzi
- San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
- Department of Surgery, University of California San Francisco, San Francisco, California, USA
| | - Warren Gasper
- San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
- Department of Surgery, University of California San Francisco, San Francisco, California, USA
| | - David Saloner
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
| | - Michael D Hope
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
| | - Dimitrios Mitsouras
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
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Mo T, Brandal SHB, Geier OM, Engebråten O, Nilsen LB, Kristensen VN, Hole KH, Hompland T, Fleischer T, Seierstad T. MRI Assessment of Changes in Tumor Vascularization during Neoadjuvant Anti-Angiogenic Treatment in Locally Advanced Breast Cancer Patients. Cancers (Basel) 2023; 15:4662. [PMID: 37760629 PMCID: PMC10526130 DOI: 10.3390/cancers15184662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/16/2023] [Accepted: 09/17/2023] [Indexed: 09/29/2023] Open
Abstract
Anti-VEGF (vascular endothelial growth factor) treatment improves response rates, but not progression-free or overall survival in advanced breast cancer. It has been suggested that subgroups of patients may benefit from this treatment; however, the effects of adding anti-VEGF treatment to a standard chemotherapy regimen in breast cancer patients are not well studied. Understanding the effects of the anti-vascular treatment on tumor vasculature may provide a selection of patients that can benefit. The aim of this study was to study the vascular effect of bevacizumab using clinical dynamic contrast-enhanced MRI (DCE-MRI). A total of 70 women were randomized to receive either chemotherapy alone or chemotherapy with bevacizumab for 25 weeks. DCE-MRI was performed at baseline and at 12 and 25 weeks, and in addition 25 of 70 patients agreed to participate in an early MRI after one week. Voxel-wise pharmacokinetic analysis was performed using semi-quantitative methods and the extended Tofts model. Vascular architecture was assessed by calculating the fractal dimension of the contrast-enhanced images. Changes during treatment were compared with baseline and between the treatment groups. There was no significant difference in tumor volume at any point; however, DCE-MRI parameters revealed differences in vascular function and vessel architecture. Adding bevacizumab to chemotherapy led to a pronounced reduction in vascular DCE-MRI parameters, indicating decreased vascularity. At 12 and 25 weeks, the difference between the treatment groups is severely reduced.
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Affiliation(s)
- Torgeir Mo
- Faculty of Clinical Medicine, University of Oslo, 0316 Oslo, Norway; (T.M.); (S.H.B.B.); (O.E.); (V.N.K.); (K.H.H.)
- Department of Cancer Genetics, Institute for Cancer Research, Oslo University Hospital, 4950 Oslo, Norway;
| | - Siri Helene Bertelsen Brandal
- Faculty of Clinical Medicine, University of Oslo, 0316 Oslo, Norway; (T.M.); (S.H.B.B.); (O.E.); (V.N.K.); (K.H.H.)
- Department of Breast Diagnostic, Oslo University Hospital, 0379 Oslo, Norway
| | - Oliver Marcel Geier
- Department of Diagnostic Physics, Oslo University Hospital, 0379 Oslo, Norway;
| | - Olav Engebråten
- Faculty of Clinical Medicine, University of Oslo, 0316 Oslo, Norway; (T.M.); (S.H.B.B.); (O.E.); (V.N.K.); (K.H.H.)
- Department of Oncology, Oslo University Hospital, 0379 Oslo, Norway
- Department of Tumor Biology, Institute for Cancer Research, Oslo University Hospital, 4950 Oslo, Norway
| | | | - Vessela N. Kristensen
- Faculty of Clinical Medicine, University of Oslo, 0316 Oslo, Norway; (T.M.); (S.H.B.B.); (O.E.); (V.N.K.); (K.H.H.)
- Department of Medical Genetics, Oslo University Hospital, 0450 Oslo, Norway
| | - Knut Håkon Hole
- Faculty of Clinical Medicine, University of Oslo, 0316 Oslo, Norway; (T.M.); (S.H.B.B.); (O.E.); (V.N.K.); (K.H.H.)
- Department of Oncologic Radiology, Division of Radiology and Nuclear Medicine, Oslo University Hospital, 0379 Oslo, Norway
| | - Tord Hompland
- Department of Radiation Biology, Oslo University Hospital, 4950 Oslo, Norway;
| | - Thomas Fleischer
- Department of Cancer Genetics, Institute for Cancer Research, Oslo University Hospital, 4950 Oslo, Norway;
| | - Therese Seierstad
- Department of Research and Development, Division for Radiology and Nuclear Medicine, Oslo University Hospital, 0379 Oslo, Norway
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25
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Li KL, Lewis D, Zhu X, Coope DJ, Djoukhadar I, King AT, Cootes T, Jackson A. A Novel Multi-Model High Spatial Resolution Method for Analysis of DCE MRI Data: Insights from Vestibular Schwannoma Responses to Antiangiogenic Therapy in Type II Neurofibromatosis. Pharmaceuticals (Basel) 2023; 16:1282. [PMID: 37765090 PMCID: PMC10534691 DOI: 10.3390/ph16091282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 09/01/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023] Open
Abstract
This study aimed to develop and evaluate a new DCE-MRI processing technique that combines LEGATOS, a dual-temporal resolution DCE-MRI technique, with multi-kinetic models. This technique enables high spatial resolution interrogation of flow and permeability effects, which is currently challenging to achieve. Twelve patients with neurofibromatosis type II-related vestibular schwannoma (20 tumours) undergoing bevacizumab therapy were imaged at 1.5 T both before and at 90 days following treatment. Using the new technique, whole-brain, high spatial resolution images of the contrast transfer coefficient (Ktrans), vascular fraction (vp), extravascular extracellular fraction (ve), capillary plasma flow (Fp), and the capillary permeability-surface area product (PS) could be obtained, and their predictive value was examined. Of the five microvascular parameters derived using the new method, baseline PS exhibited the strongest correlation with the baseline tumour volume (p = 0.03). Baseline ve showed the strongest correlation with the change in tumour volume, particularly the percentage tumour volume change at 90 days after treatment (p < 0.001), and PS demonstrated a larger reduction at 90 days after treatment (p = 0.0001) when compared to Ktrans or Fp alone. Both the capillary permeability-surface area product (PS) and the extravascular extracellular fraction (ve) significantly differentiated the 'responder' and 'non-responder' tumour groups at 90 days (p < 0.05 and p < 0.001, respectively). These results highlight that this novel DCE-MRI analysis approach can be used to evaluate tumour microvascular changes during treatment and the need for future larger clinical studies investigating its role in predicting antiangiogenic therapy response.
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Affiliation(s)
- Ka-Loh Li
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK; (K.-L.L.); (T.C.); (A.J.)
- Geoffrey Jefferson Brain Research Centre, University of Manchester, Manchester M13 9PL, UK; (D.L.); (D.J.C.); (A.T.K.)
| | - Daniel Lewis
- Geoffrey Jefferson Brain Research Centre, University of Manchester, Manchester M13 9PL, UK; (D.L.); (D.J.C.); (A.T.K.)
- Department of Neurosurgery, Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M13 9NT, UK
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK
| | - Xiaoping Zhu
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK; (K.-L.L.); (T.C.); (A.J.)
- Wolfson Molecular Imaging Centre, University of Manchester, 27 Palatine Road, Manchester M20 3LJ, UK
| | - David J. Coope
- Geoffrey Jefferson Brain Research Centre, University of Manchester, Manchester M13 9PL, UK; (D.L.); (D.J.C.); (A.T.K.)
- Department of Neurosurgery, Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M13 9NT, UK
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK
| | - Ibrahim Djoukhadar
- Department of Neuroradiology, Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M13 9NT, UK;
| | - Andrew T. King
- Geoffrey Jefferson Brain Research Centre, University of Manchester, Manchester M13 9PL, UK; (D.L.); (D.J.C.); (A.T.K.)
- Department of Neurosurgery, Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M13 9NT, UK
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester M13 9PL, UK
| | - Timothy Cootes
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK; (K.-L.L.); (T.C.); (A.J.)
| | - Alan Jackson
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK; (K.-L.L.); (T.C.); (A.J.)
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Wu C, Wang N, Gaddam S, Wang L, Han H, Sung K, Christodoulou AG, Xie Y, Pandol S, Li D. Retrospective quantification of clinical abdominal DCE-MRI using pharmacokinetics-informed deep learning: a proof-of-concept study. FRONTIERS IN RADIOLOGY 2023; 3:1168901. [PMID: 37731600 PMCID: PMC10507354 DOI: 10.3389/fradi.2023.1168901] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/24/2023] [Indexed: 09/22/2023]
Abstract
Introduction Dynamic contrast-enhanced (DCE) MRI has important clinical value for early detection, accurate staging, and therapeutic monitoring of cancers. However, conventional multi-phasic abdominal DCE-MRI has limited temporal resolution and provides qualitative or semi-quantitative assessments of tissue vascularity. In this study, the feasibility of retrospectively quantifying multi-phasic abdominal DCE-MRI by using pharmacokinetics-informed deep learning to improve temporal resolution was investigated. Method Forty-five subjects consisting of healthy controls, pancreatic ductal adenocarcinoma (PDAC), and chronic pancreatitis (CP) were imaged with a 2-s temporal-resolution quantitative DCE sequence, from which 30-s temporal-resolution multi-phasic DCE-MRI was synthesized based on clinical protocol. A pharmacokinetics-informed neural network was trained to improve the temporal resolution of the multi-phasic DCE before the quantification of pharmacokinetic parameters. Through ten-fold cross-validation, the agreement between pharmacokinetic parameters estimated from synthesized multi-phasic DCE after deep learning inference was assessed against reference parameters from the corresponding quantitative DCE-MRI images. The ability of the deep learning estimated parameters to differentiate abnormal from normal tissues was assessed as well. Results The pharmacokinetic parameters estimated after deep learning have a high level of agreement with the reference values. In the cross-validation, all three pharmacokinetic parameters (transfer constant K trans , fractional extravascular extracellular volume v e , and rate constant k ep ) achieved intraclass correlation coefficient and R2 between 0.84-0.94, and low coefficients of variation (10.1%, 12.3%, and 5.6%, respectively) relative to the reference values. Significant differences were found between healthy pancreas, PDAC tumor and non-tumor, and CP pancreas. Discussion Retrospective quantification (RoQ) of clinical multi-phasic DCE-MRI is possible by deep learning. This technique has the potential to derive quantitative pharmacokinetic parameters from clinical multi-phasic DCE data for a more objective and precise assessment of cancer.
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Affiliation(s)
- Chaowei Wu
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA, United States
| | - Nan Wang
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
- Radiology Department, Stanford University, Stanford, CA, United States
| | - Srinivas Gaddam
- Division of Digestive and Liver Diseases, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Lixia Wang
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Hui Han
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Kyunghyun Sung
- Department of Radiological Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Anthony G. Christodoulou
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA, United States
| | - Yibin Xie
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Stephen Pandol
- Division of Digestive and Liver Diseases, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Debiao Li
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA, United States
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Zhou X, Fan X, Chatterjee A, Yousuf A, Antic T, Oto A, Karczmar GS. Parametric maps of spatial two-tissue compartment model for prostate dynamic contrast enhanced MRI - comparison with the standard tofts model in the diagnosis of prostate cancer. Phys Eng Sci Med 2023; 46:1215-1226. [PMID: 37432557 DOI: 10.1007/s13246-023-01289-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 06/14/2023] [Indexed: 07/12/2023]
Abstract
The spatial two-tissue compartment model (2TCM) was used to analyze prostate dynamic contrast enhanced (DCE) MRI data and compared with the standard Tofts model. A total of 29 patients with biopsy-confirmed prostate cancer were included in this IRB-approved study. MRI data were acquired on a Philips Achieva 3T-TX scanner. After T2-weighted and diffusion-weighted imaging, DCE data using 3D T1-FFE mDIXON sequence were acquired pre- and post-contrast media injection (0.1 mmol/kg Multihance) for 60 dynamic scans with temporal resolution of 8.3 s/image. The 2TCM has one fast ([Formula: see text] and [Formula: see text]) and one slow ([Formula: see text] and [Formula: see text]) exchanging compartment, compared with the standard Tofts model parameters (Ktrans and kep). On average, prostate cancer had significantly higher values (p < 0.01) than normal prostate tissue for all calculated parameters. There was a strong correlation (r = 0.94, p < 0.001) between Ktrans and [Formula: see text] for cancer, but weak correlation (r = 0.28, p < 0.05) between kep and [Formula: see text]. Average root-mean-square error (RMSE) in fits from the 2TCM was significantly smaller (p < 0.001) than the RMSE in fits from the Tofts model. Receiver operating characteristic (ROC) analysis showed that fast [Formula: see text] had the highest area under the curve (AUC) than any other individual parameter. The combined four parameters from the 2TCM had a considerably higher AUC value than the combined two parameters from the Tofts model. The 2TCM is useful for quantitative analysis of prostate DCE-MRI data and provides new information in the diagnosis of prostate cancer.
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Affiliation(s)
- Xueyan Zhou
- School of Technology, Harbin University, Harbin, China.
- Department of Radiology, University of Chicago, Chicago, IL, 60637, USA.
| | - Xiaobing Fan
- Department of Radiology, University of Chicago, Chicago, IL, 60637, USA
| | | | - Ambereen Yousuf
- Department of Radiology, University of Chicago, Chicago, IL, 60637, USA
| | - Tatjana Antic
- Department of Pathology, University of Chicago, Chicago, IL, 60637, USA
| | - Aytekin Oto
- Department of Radiology, University of Chicago, Chicago, IL, 60637, USA
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28
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Sánchez Iglesias Á, Morillo Macías V, Picó Peris A, Fuster-Matanzo A, Nogué Infante A, Muelas Soria R, Bellvís Bataller F, Domingo Pomar M, Casillas Meléndez C, Yébana Huertas R, Ferrer Albiach C. Prostate Region-Wise Imaging Biomarker Profiles for Risk Stratification and Biochemical Recurrence Prediction. Cancers (Basel) 2023; 15:4163. [PMID: 37627191 PMCID: PMC10453281 DOI: 10.3390/cancers15164163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/10/2023] [Accepted: 08/13/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Identifying prostate cancer (PCa) patients with a worse prognosis and a higher risk of biochemical recurrence (BCR) is essential to guide treatment choices. Here, we aimed to identify possible imaging biomarker (perfusion/diffusion + radiomic features) profiles extracted from MRIs that were able to discriminate patients according to their risk or the occurrence of BCR 10 years after diagnosis, as well as to evaluate their predictive value with or without clinical data. METHODS Patients with localized PCa receiving neoadjuvant androgen deprivation therapy and radiotherapy were retrospectively evaluated. Imaging features were extracted from MRIs for each prostate region or for the whole gland. Univariate and multivariate analyses were conducted. RESULTS 128 patients (mean [range] age, 71 [50-83] years) were included. Prostate region-wise imaging biomarker profiles mainly composed of radiomic features allowed discriminating risk groups and patients experiencing BCR. Heterogeneity-related radiomic features were increased in patients with worse prognosis and with BCR. Overall, imaging biomarkers profiles retained good predictive ability (AUC values superior to 0.725 in most cases), which generally improved when clinical data were included (particularly evident for the prediction of the BCR, with AUC values ranging from 0.841 to 0.877 for combined models and sensitivity values above 0.960) and when models were built per prostate region vs. the whole gland. CONCLUSIONS Prostate region-aware imaging profiles enable identification of patients with worse prognosis and with a higher risk of BCR, retaining higher predictive values when combined with clinical variables.
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Affiliation(s)
- Ángel Sánchez Iglesias
- Radiation Oncology Department, Hospital Provincial de Castellón, 12002 Castellón, Spain; (Á.S.I.); (V.M.M.); (R.M.S.)
| | - Virginia Morillo Macías
- Radiation Oncology Department, Hospital Provincial de Castellón, 12002 Castellón, Spain; (Á.S.I.); (V.M.M.); (R.M.S.)
| | - Alfonso Picó Peris
- Quantitative Imaging Biomarkers in Medicine (Quibim), 46021 Valencia, Spain; (A.P.P.); (A.F.-M.); (A.N.I.); (F.B.B.); (M.D.P.); (R.Y.H.)
| | - Almudena Fuster-Matanzo
- Quantitative Imaging Biomarkers in Medicine (Quibim), 46021 Valencia, Spain; (A.P.P.); (A.F.-M.); (A.N.I.); (F.B.B.); (M.D.P.); (R.Y.H.)
| | - Anna Nogué Infante
- Quantitative Imaging Biomarkers in Medicine (Quibim), 46021 Valencia, Spain; (A.P.P.); (A.F.-M.); (A.N.I.); (F.B.B.); (M.D.P.); (R.Y.H.)
| | - Rodrigo Muelas Soria
- Radiation Oncology Department, Hospital Provincial de Castellón, 12002 Castellón, Spain; (Á.S.I.); (V.M.M.); (R.M.S.)
| | - Fuensanta Bellvís Bataller
- Quantitative Imaging Biomarkers in Medicine (Quibim), 46021 Valencia, Spain; (A.P.P.); (A.F.-M.); (A.N.I.); (F.B.B.); (M.D.P.); (R.Y.H.)
| | - Marcos Domingo Pomar
- Quantitative Imaging Biomarkers in Medicine (Quibim), 46021 Valencia, Spain; (A.P.P.); (A.F.-M.); (A.N.I.); (F.B.B.); (M.D.P.); (R.Y.H.)
| | | | - Raúl Yébana Huertas
- Quantitative Imaging Biomarkers in Medicine (Quibim), 46021 Valencia, Spain; (A.P.P.); (A.F.-M.); (A.N.I.); (F.B.B.); (M.D.P.); (R.Y.H.)
| | - Carlos Ferrer Albiach
- Radiation Oncology Department, Hospital Provincial de Castellón, 12002 Castellón, Spain; (Á.S.I.); (V.M.M.); (R.M.S.)
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Han Z, MacCuaig WM, Gurcan MN, Claros-Sorto J, Garwe T, Henson C, Holter-Chakrabarty J, Hannafon B, Chandra V, Wellberg E, McNally LR. Dynamic 2-deoxy-D-glucose-enhanced multispectral optoacoustic tomography for assessing metabolism and vascular hemodynamics of breast cancer. PHOTOACOUSTICS 2023; 32:100531. [PMID: 37485041 PMCID: PMC10362308 DOI: 10.1016/j.pacs.2023.100531] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 06/22/2023] [Accepted: 07/08/2023] [Indexed: 07/25/2023]
Abstract
Clinical tools for measuring tumor vascular hemodynamics, such as dynamic contrast-enhanced MRI, are clinically important to assess tumor properties. Here we explored the use of multispectral optoacoustic tomography (MSOT), which has a high spatial and temporal resolution, to measure the intratumoral pharmacokinetics of a near-infrared-dye-labeled 2-Deoxyglucose, 2-DG-800, in orthotropic 2-LMP breast tumors in mice. As uptake of 2-DG-800 is dependent on both vascular properties, and glucose transporter activity - a widely-used surrogate for metabolism, we evaluate hemodynamics of 2-DG-MP by fitting the dynamic MSOT signal of 2-DG-800 into two-compartment models including the extended Tofts model (ETM) and reference region model (RRM). We showed that dynamic 2-DG-enhanced MSOT (DGE-MSOT) is powerful in acquiring hemodynamic rate constants, including Ktrans and Kep, via systemically injecting a low dose of 2-DG-800 (0.5 µmol/kg b.w.). In our study, both ETM and RRM are efficient in deriving hemodynamic parameters in the tumor. Area-under-curve (AUC) values (which correlate to metabolism), and Ktrans and Kep values, can effectively distinguish tumor from muscle. Hemodynamic parameters also demonstrated correlations to hemoglobin, oxyhemoglobin, and blood oxygen level (SO2) measurements by spectral unmixing of the MSOT data. Together, our study for the first time demonstrated the capability of DGE-MSOT in assessing vascular hemodynamics of tumors.
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Affiliation(s)
- Zheng Han
- Department of Surgery, University of Oklahoma Health Science Center, Oklahoma City, OK 73104, USA
- Center for Health Systems Innovation, Oklahoma State University, Stillwater, OK 74078, USA
| | - William M. MacCuaig
- Department of Surgery, University of Oklahoma Health Science Center, Oklahoma City, OK 73104, USA
- Department of Bioengineering, University of Oklahoma, Norman, OK 73019, USA
| | - Metin N. Gurcan
- Center for Biomedical Informatics, Wake Forest Baptist Health, Winston-Salem, NC 27101, USA
| | - Juan Claros-Sorto
- Department of Surgery, University of Oklahoma Health Science Center, Oklahoma City, OK 73104, USA
| | - Tabitha Garwe
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Science Center, Oklahoma City, OK 73104, USA
| | - Christina Henson
- Department of Internal Medicine, University of Oklahoma Health Science Center, Oklahoma City, OK 73104, USA
| | | | - Bethany Hannafon
- Department of Obstetrics and Gynecology, University of Oklahoma Health Science Center, Oklahoma City, OK 73104, USA
| | - Vishal Chandra
- Department of Obstetrics and Gynecology, University of Oklahoma Health Science Center, Oklahoma City, OK 73104, USA
| | - Elizabeth Wellberg
- Department of Pathology, University of Oklahoma Health Science Center, Oklahoma City, OK 73104, USA
| | - Lacey R. McNally
- Department of Surgery, University of Oklahoma Health Science Center, Oklahoma City, OK 73104, USA
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30
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Conq J, Joudiou N, Ucakar B, Vanvarenberg K, Préat V, Gallez B. Assessment of Hyperosmolar Blood-Brain Barrier Opening in Glioblastoma via Histology with Evans Blue and DCE-MRI. Biomedicines 2023; 11:1957. [PMID: 37509598 PMCID: PMC10377677 DOI: 10.3390/biomedicines11071957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/02/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND While the blood-brain barrier (BBB) is often compromised in glioblastoma (GB), the perfusion and consequent delivery of drugs are highly heterogeneous. Moreover, the accessibility of drugs is largely impaired in the margins of the tumor and for infiltrating cells at the origin of tumor recurrence. In this work, we evaluate the value of methods to assess hemodynamic changes induced by a hyperosmolar shock in the core and the margins of a tumor in a GB model. METHODS Osmotic shock was induced with an intracarotid infusion of a hypertonic solution of mannitol in mice grafted with U87-MG cells. The distribution of fluorescent dye (Evans blue) within the brain was assessed via histology. Dynamic contrast-enhanced (DCE)-MRI with an injection of Gadolinium-DOTA as the contrast agent was also used to evaluate the effect on hemodynamic parameters and the diffusion of the contrast agent outside of the tumor area. RESULTS The histological study revealed that the fluorescent dye diffused much more largely outside of the tumor area after osmotic shock than in control tumors. However, the study of tumor hemodynamic parameters via DCE-MRI did not reveal any change in the permeability of the BBB, whatever the studied MRI parameter. CONCLUSIONS The use of hypertonic mannitol infusion seems to be a promising method to increase the delivery of compounds in the margins of GB. Nevertheless, the DCE-MRI analysis method using gadolinium-DOTA as a contrast agent seems of limited value for determining the efficacy of opening the BBB in GB after osmotic shock.
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Affiliation(s)
- Jérôme Conq
- UCLouvain, Louvain Drug Research Institute (LDRI), Biomedical Magnetic Resonance Research Group, 1200 Brussels, Belgium
- UCLouvain, Louvain Drug Research Institute (LDRI), Advanced Drug Delivery and Biomaterials Research Group, 1200 Brussels, Belgium
| | - Nicolas Joudiou
- UCLouvain, Louvain Drug Research Institute (LDRI), Nuclear and Electron Spin Technologies (NEST) Platform, 1200 Brussels, Belgium
| | - Bernard Ucakar
- UCLouvain, Louvain Drug Research Institute (LDRI), Advanced Drug Delivery and Biomaterials Research Group, 1200 Brussels, Belgium
| | - Kevin Vanvarenberg
- UCLouvain, Louvain Drug Research Institute (LDRI), Advanced Drug Delivery and Biomaterials Research Group, 1200 Brussels, Belgium
| | - Véronique Préat
- UCLouvain, Louvain Drug Research Institute (LDRI), Advanced Drug Delivery and Biomaterials Research Group, 1200 Brussels, Belgium
| | - Bernard Gallez
- UCLouvain, Louvain Drug Research Institute (LDRI), Biomedical Magnetic Resonance Research Group, 1200 Brussels, Belgium
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31
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Tang MCY, Ferreira TA, Marinkovic M, Jaarsma-Coes MG, Klaassen L, Vu THK, Creutzberg CL, Rodrigues MF, Horeweg N, Klaver YLB, Rasch CRN, Luyten GPM, Beenakker JWM. MR-based follow-up after brachytherapy and proton beam therapy in uveal melanoma. Neuroradiology 2023:10.1007/s00234-023-03166-1. [PMID: 37249621 DOI: 10.1007/s00234-023-03166-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 05/14/2023] [Indexed: 05/31/2023]
Abstract
PURPOSE MRI is increasingly used in the diagnosis and therapy planning of uveal melanoma (UM). In this prospective cohort study, we assessed the radiological characteristics, in terms of anatomical and functional imaging, of UM after ruthenium-106 plaque brachytherapy or proton beam therapy (PBT) and compared them to conventional ultrasound. METHODS Twenty-six UM patients were evaluated before and 3, 6 and 12 months after brachytherapy (n = 13) or PBT (n = 13). Tumour prominences were compared between ultrasound and MRI. On diffusion-weighted imaging, the apparent diffusion value (ADC), and on perfusion-weighted imaging (PWI), the time-intensity curves (TIC), relative peak intensity and outflow percentages were determined. Values were compared between treatments and with baseline. RESULTS Pre-treatment prominences were comparable between MRI and ultrasound (mean absolute difference 0.51 mm, p = 0.46), but larger differences were observed post-treatment (e.g. 3 months: 0.9 mm (p = 0.02)). Pre-treatment PWI metrics were comparable between treatment groups. After treatment, brachytherapy patients showed favourable changes on PWI (e.g. 67% outflow reduction at 3 months, p < 0.01). After PBT, significant perfusion changes were observed at a later timepoint (e.g. 38% outflow reduction at 6 months, p = 0.01). No consistent ADC changes were observed after either treatment, e.g. a 0.11 × 10-3mm2/s increase 12 months after treatment (p = 0.15). CONCLUSION MR-based follow-up is valuable for PBT-treated patients as favourable perfusion changes, including a reduction in outflow, can be detected before a reduction in size is apparent on ultrasound. For brachytherapy, a follow-up MRI is of less value as already 3 months post-treatment a significant size reduction can be measured on ultrasound.
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Affiliation(s)
- Michael C Y Tang
- Department of Ophthalmology, Leiden University Medical Center, P.O. 9600, 2300, RC, Leiden, The Netherlands.
- Department of Radiology, Leiden University Medical Center, Leiden, Netherlands.
| | - Teresa A Ferreira
- Department of Radiology, Leiden University Medical Center, Leiden, Netherlands
| | - Marina Marinkovic
- Department of Ophthalmology, Leiden University Medical Center, P.O. 9600, 2300, RC, Leiden, The Netherlands
| | - Myriam G Jaarsma-Coes
- Department of Ophthalmology, Leiden University Medical Center, P.O. 9600, 2300, RC, Leiden, The Netherlands
- Department of Radiology, Leiden University Medical Center, Leiden, Netherlands
| | - Lisa Klaassen
- Department of Ophthalmology, Leiden University Medical Center, P.O. 9600, 2300, RC, Leiden, The Netherlands
- Department of Radiology, Leiden University Medical Center, Leiden, Netherlands
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, Netherlands
| | - T H Khanh Vu
- Department of Ophthalmology, Leiden University Medical Center, P.O. 9600, 2300, RC, Leiden, The Netherlands
| | - Carien L Creutzberg
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, Netherlands
| | - Myra F Rodrigues
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, Netherlands
- Holland Proton Therapy Center, Delft, Netherlands
| | - Nanda Horeweg
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, Netherlands
| | - Yvonne L B Klaver
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, Netherlands
- Holland Proton Therapy Center, Delft, Netherlands
| | - Coen R N Rasch
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, Netherlands
- Holland Proton Therapy Center, Delft, Netherlands
| | - Gre P M Luyten
- Department of Ophthalmology, Leiden University Medical Center, P.O. 9600, 2300, RC, Leiden, The Netherlands
| | - Jan-Willem M Beenakker
- Department of Ophthalmology, Leiden University Medical Center, P.O. 9600, 2300, RC, Leiden, The Netherlands
- Department of Radiology, Leiden University Medical Center, Leiden, Netherlands
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, Netherlands
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32
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Hoffmann E, Gerwing M, Krähling T, Hansen U, Kronenberg K, Masthoff M, Geyer C, Höltke C, Wachsmuth L, Schinner R, Hoerr V, Heindel W, Karst U, Eisenblätter M, Maus B, Helfen A, Faber C, Wildgruber M. Vascular response patterns to targeted therapies in murine breast cancer models with divergent degrees of malignancy. Breast Cancer Res 2023; 25:56. [PMID: 37221619 DOI: 10.1186/s13058-023-01658-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 05/14/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND Response assessment of targeted cancer therapies is becoming increasingly challenging, as it is not adequately assessable with conventional morphological and volumetric analyses of tumor lesions. The tumor microenvironment is particularly constituted by tumor vasculature which is altered by various targeted therapies. The aim of this study was to noninvasively assess changes in tumor perfusion and vessel permeability after targeted therapy in murine models of breast cancer with divergent degrees of malignancy. METHODS Low malignant 67NR or highly malignant 4T1 tumor-bearing mice were treated with either the multi-kinase inhibitor sorafenib or immune checkpoint inhibitors (ICI, combination of anti-PD1 and anti-CTLA4). Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) with i.v. injection of albumin-binding gadofosveset was conducted on a 9.4 T small animal MRI. Ex vivo validation of MRI results was achieved by transmission electron microscopy, immunohistochemistry and laser ablation-inductively coupled plasma-mass spectrometry. RESULTS Therapy-induced changes in tumor vasculature differed between low and highly malignant tumors. Sorafenib treatment led to decreased tumor perfusion and endothelial permeability in low malignant 67NR tumors. In contrast, highly malignant 4T1 tumors demonstrated characteristics of a transient window of vascular normalization with an increase in tumor perfusion and permeability early after therapy initiation, followed by decreased perfusion and permeability parameters. In the low malignant 67NR model, ICI treatment also mediated vessel-stabilizing effects with decreased tumor perfusion and permeability, while ICI-treated 4T1 tumors exhibited increasing tumor perfusion with excessive vascular leakage. CONCLUSION DCE-MRI enables noninvasive assessment of early changes in tumor vasculature after targeted therapies, revealing different response patterns between tumors with divergent degrees of malignancy. DCE-derived tumor perfusion and permeability parameters may serve as vascular biomarkers that allow for repetitive examination of response to antiangiogenic treatment or immunotherapy.
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Grants
- 446302350, 194468054, 431460824 Deutsche Forschungsgemeinschaft
- 446302350, 194468054, 431460824 Deutsche Forschungsgemeinschaft
- 446302350, 194468054, 431460824 Deutsche Forschungsgemeinschaft
- 446302350, 194468054, 431460824 Deutsche Forschungsgemeinschaft
- 446302350, 194468054, 431460824 Deutsche Forschungsgemeinschaft
- 446302350, 194468054, 431460824 Deutsche Forschungsgemeinschaft
- 446302350, 194468054, 431460824 Deutsche Forschungsgemeinschaft
- 446302350, 194468054, 431460824 Deutsche Forschungsgemeinschaft
- 446302350, 194468054, 431460824 Deutsche Forschungsgemeinschaft
- 446302350, 194468054, 431460824 Deutsche Forschungsgemeinschaft
- 446302350, 194468054, 431460824 Deutsche Forschungsgemeinschaft
- 446302350, 194468054, 431460824 Deutsche Forschungsgemeinschaft
- 446302350, 194468054, 431460824 Deutsche Forschungsgemeinschaft
- 446302350, 194468054, 431460824 Deutsche Forschungsgemeinschaft
- 446302350, 194468054, 431460824 Deutsche Forschungsgemeinschaft
- 446302350, 194468054, 431460824 Deutsche Forschungsgemeinschaft
- 446302350, 194468054, 431460824 Deutsche Forschungsgemeinschaft
- 446302350, 194468054, 431460824 Deutsche Forschungsgemeinschaft
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Affiliation(s)
- Emily Hoffmann
- Clinic of Radiology, University of Münster, Münster, Germany.
| | - Mirjam Gerwing
- Clinic of Radiology, University of Münster, Münster, Germany
| | - Tobias Krähling
- Clinic of Radiology, University of Münster, Münster, Germany
| | - Uwe Hansen
- Institute for Musculoskeletal Medicine, University of Münster, Münster, Germany
| | - Katharina Kronenberg
- Institute of Inorganic and Analytical Chemistry, University of Münster, Münster, Germany
| | - Max Masthoff
- Clinic of Radiology, University of Münster, Münster, Germany
| | | | - Carsten Höltke
- Clinic of Radiology, University of Münster, Münster, Germany
| | - Lydia Wachsmuth
- Clinic of Radiology, University of Münster, Münster, Germany
| | - Regina Schinner
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Verena Hoerr
- Clinic of Radiology, University of Münster, Münster, Germany
- Heart Center Bonn, Department of Internal Medicine II, University Hospital Bonn, Bonn, Germany
| | - Walter Heindel
- Clinic of Radiology, University of Münster, Münster, Germany
| | - Uwe Karst
- Institute of Inorganic and Analytical Chemistry, University of Münster, Münster, Germany
| | - Michel Eisenblätter
- Clinic of Radiology, University of Münster, Münster, Germany
- Department of Diagnostic and Interventional Radiology, Medical Faculty OWL, University of Bielefeld, Bielefeld, Germany
| | - Bastian Maus
- Clinic of Radiology, University of Münster, Münster, Germany
| | - Anne Helfen
- Clinic of Radiology, University of Münster, Münster, Germany
| | - Cornelius Faber
- Clinic of Radiology, University of Münster, Münster, Germany
| | - Moritz Wildgruber
- Clinic of Radiology, University of Münster, Münster, Germany
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
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Laothamatas I, Al Mubarak H, Reddy A, Wax R, Badani K, Taouli B, Bane O, Lewis S. Multiparametric MRI of Solid Renal Masses: Principles and Applications of Advanced Quantitative and Functional Methods for Tumor Diagnosis and Characterization. J Magn Reson Imaging 2023. [PMID: 37052601 DOI: 10.1002/jmri.28718] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/23/2023] [Accepted: 03/23/2023] [Indexed: 04/14/2023] Open
Abstract
Solid renal masses (SRMs) are increasingly detected and encompass both benign and malignant masses, with renal cell carcinoma (RCC) being the most common malignant SRM. Most patients with SRMs will undergo management without a priori pathologic confirmation. There is an unmet need to noninvasively diagnose and characterize RCCs, as significant variability in clinical behavior is observed and a wide range of differing management options exist. Cross-sectional imaging modalities, including magnetic resonance imaging (MRI), are increasingly used for SRM characterization. Multiparametric (mp) MRI techniques can provide insight into tumor biology by probing different physiologic/pathophysiologic processes noninvasively. These include sequences that probe tissue microstructure, including intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) and T1 relaxometry; oxygen metabolism (blood oxygen level dependent [BOLD-MRI]); as well as vascular flow and perfusion (dynamic contrast-enhanced MRI [DCE-MRI] and arterial spin labeling [ASL]). In this review, we will discuss each mpMRI method in terms of its principles, roles, and discuss the results of human studies for SRM assessment. Future validation of these methods may help to enable a personalized management approach for patients with SRM in the emerging era of precision medicine. EVIDENCE LEVEL: 5. TECHNICAL EFFICACY: 2.
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Affiliation(s)
- Indira Laothamatas
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Haitham Al Mubarak
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Arthi Reddy
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Rebecca Wax
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ketan Badani
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Bachir Taouli
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Octavia Bane
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Sara Lewis
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Roberts J, Kim SE, Kholmovski EG, Hitchcock Y, Richards TJ, Anzai Y. The arterial input function: Spatial dependence within the imaging volume and its influence on 3D quantitative dynamic contrast-enhanced MRI for head and neck cancer. Magn Reson Imaging 2023; 101:40-46. [PMID: 37030177 DOI: 10.1016/j.mri.2023.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 03/21/2023] [Indexed: 04/10/2023]
Abstract
PURPOSE To evaluate the dependence of the arterial input function (AIF) on the imaging z-axis and its effect on 3D DCE MRI pharmacokinetic parameters as mediated by the SPGR signal equation and Extended Tofts-Kermode model. THEORY For SPGR-based 3D DCE MRI acquisition of the head and neck, inflow effects within vessels violate the assumptions underlying the SPGR signal model. Errors in the SPGR-based AIF estimate propagate through the Extended Tofts-Kermode model to affect the output pharmacokinetic parameters. MATERIALS AND METHODS 3D DCE-MRI data were acquired for six newly diagnosed HNC patients in a prospective single arm cohort study. AIF were selected within the carotid arteries at each z-axis location. A region of interest (ROI) was placed in normal paravertebral muscle and the Extended Tofts-Kermode model solved for each pixel within the ROI for each AIF. Results were compared to those obtained with a published population average AIF. RESULTS Due to inflow effect, the AIF showed extreme variation in their temporal shapes. Ktrans was most sensitive to the initial bolus concentration and showed more variation over the muscle ROI with AIF taken from the upstream portion of the carotid. kep was less sensitive to the peak bolus concentration and showed less variation for AIF taken from the upstream portion of the carotid. CONCLUSION Inflow effects may introduce an unknown bias to SPGR-based 3D DCE pharmacokinetic parameters. Variation in the computed parameters depends on the selected AIF location. In the context of high flow, measurements may be limited to relative rather than absolute quantitative parameters.
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Affiliation(s)
- John Roberts
- Dept. Radiology & Imaging Sciences, University of Utah, SLC, UT, USA..
| | - Seong-Eun Kim
- Dept. Radiology & Imaging Sciences, University of Utah, SLC, UT, USA
| | - Eugene G Kholmovski
- Dept. Radiology & Imaging Sciences, University of Utah, SLC, UT, USA.; Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Ying Hitchcock
- Radiation Oncology, Huntsman Cancer Institute, SLC, UT, USA
| | | | - Yoshimi Anzai
- Dept. Radiology & Imaging Sciences, University of Utah, SLC, UT, USA
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Zhang Q, Luo X, Zhou L, Nguyen TD, Prince MR, Spincemaille P, Wang Y. Fluid Mechanics Approach to Perfusion Quantification: Vasculature Computational Fluid Dynamics Simulation, Quantitative Transport Mapping (QTM) Analysis of Dynamics Contrast Enhanced MRI, and Application in Nonalcoholic Fatty Liver Disease Classification. IEEE Trans Biomed Eng 2023; 70:980-990. [PMID: 36107908 DOI: 10.1109/tbme.2022.3207057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE We quantify liver perfusion using quantitative transport mapping (QTM) method that is free of arterial input function (AIF). QTM method is validated in a vasculature computational fluid dynamics (CFD) simulation and is applied for processing dynamic contrast enhanced (DCE) MRI images in differentiating liver with nonalcoholic fatty liver disease (NAFLD) from healthy controls using pathology reference in a preclinical rabbit model. METHODS QTM method was validated on a liver perfusion simulation based on fluid dynamics using a rat liver vasculature model and the mass transport equation. In the NAFLD grading task, DCE MRI images of 7 adult rabbits with methionine choline-deficient diet-induced nonalcoholic steatohepatitis (NASH), 8 adult rabbits with simple steatosis (SS) were acquired and processed using QTM method and dual-input two compartment Kety's method respectively. Statistical analysis was performed on six perfusion parameters: velocity magnitude | u | derived from QTM, liver arterial blood flow LBFa, liver venous blood flow LBFv, permeability Ktrans, blood volume Vp and extravascular space volume Ve averaged in liver ROI. RESULTS In the simulation, QTM method successfully reconstructed blood flow, reduced error by 48% compared to Kety's method. In the preclinical study, only QTM |u| showed significant difference between high grade NAFLD group and low grade NAFLD group. CONCLUSION QTM postprocesses DCE-MRI automatically through deconvolution in space and time to solve the inverse problem of the transport equation. Comparing with Kety's method, QTM method showed higher accuracy and better differentiation in NAFLD classification task. SIGNIFICANCE We propose to apply QTM method in liver DCE MRI perfusion quantification.
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36
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Harris WJ, Asselin MC, Hinz R, Parkes LM, Allan S, Schiessl I, Boutin H, Dickie BR. In vivo methods for imaging blood-brain barrier function and dysfunction. Eur J Nucl Med Mol Imaging 2023; 50:1051-1083. [PMID: 36437425 PMCID: PMC9931809 DOI: 10.1007/s00259-022-05997-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 10/09/2022] [Indexed: 11/29/2022]
Abstract
The blood-brain barrier (BBB) is the interface between the central nervous system and systemic circulation. It tightly regulates what enters and is removed from the brain parenchyma and is fundamental in maintaining brain homeostasis. Increasingly, the BBB is recognised as having a significant role in numerous neurological disorders, ranging from acute disorders (traumatic brain injury, stroke, seizures) to chronic neurodegeneration (Alzheimer's disease, vascular dementia, small vessel disease). Numerous approaches have been developed to study the BBB in vitro, in vivo, and ex vivo. The complex multicellular structure and effects of disease are difficult to recreate accurately in vitro, and functional aspects of the BBB cannot be easily studied ex vivo. As such, the value of in vivo methods to study the intact BBB cannot be overstated. This review discusses the structure and function of the BBB and how these are affected in diseases. It then discusses in depth several established and novel methods for imaging the BBB in vivo, with a focus on MRI, nuclear imaging, and high-resolution intravital fluorescence microscopy.
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Affiliation(s)
- William James Harris
- Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Northern Care Alliance & University of Manchester, Manchester, UK
- Division of Neuroscience, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, M13 9PL, Manchester, UK
| | - Marie-Claude Asselin
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, University of Manchester, Manchester, UK
| | - Rainer Hinz
- Wolfson Molecular Imaging Centre, University of Manchester, Manchester, UK
| | - Laura Michelle Parkes
- Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Northern Care Alliance & University of Manchester, Manchester, UK
- Division of Neuroscience, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, M13 9PL, Manchester, UK
| | - Stuart Allan
- Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Northern Care Alliance & University of Manchester, Manchester, UK
- Division of Neuroscience, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, M13 9PL, Manchester, UK
| | - Ingo Schiessl
- Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Northern Care Alliance & University of Manchester, Manchester, UK
- Division of Neuroscience, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, M13 9PL, Manchester, UK
| | - Herve Boutin
- Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Northern Care Alliance & University of Manchester, Manchester, UK.
- Division of Neuroscience, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, M13 9PL, Manchester, UK.
- Wolfson Molecular Imaging Centre, University of Manchester, Manchester, UK.
| | - Ben Robert Dickie
- Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Northern Care Alliance & University of Manchester, Manchester, UK
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, University of Manchester, Manchester, UK
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Zhou X, Fan X, Chatterjee A, Yousuf A, Antic T, Oto A, Karczmar GS. Parametric maps of spatial two-tissue compartment model for prostate dynamic contrast enhanced MRI - comparison with the standard Tofts model in the diagnosis of prostate cancer. RESEARCH SQUARE 2023:rs.3.rs-2539644. [PMID: 36798227 PMCID: PMC9934750 DOI: 10.21203/rs.3.rs-2539644/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
The spatial two-tissue compartment model (2TCM) was used to analyze prostate dynamic contrast enhanced (DCE) MRI data and compared with the standard Tofts model. A total of 29 patients with biopsy-confirmed prostate cancer were included in this IRB-approved study. MRI data were acquired on a Philips Achieva 3T-TX scanner. After T2-weighted and diffusion-weighted imaging, DCE data using 3D T1-FFE mDIXON sequence were acquired pre- and post-contrast media injection (0.1 mmol/kg Multihance) for 60 dynamic scans with temporal resolution of 8.3 s/image. The 2TCM has one fast (K 1 trans and k 1 ep ) and one slow (K 2 trans and k 2 ep ) exchanging compartment, compared with the standard Tofts model parameters (K trans and k ep ). On average, prostate cancer had significantly higher values (p < 0.007) than normal prostate tissue for all calculated parameters. There was a strong correlation (r = 0.94, p < 0.0001) between K trans and K 1 trans for cancer, but weak correlation (r = 0.28, p < 0.05) between k ep and k 1 ep . Average root-mean-square error (RMSE) in fits from the 2TCM was significantly smaller (p < 0.001) than the RMSE in fits from the Tofts model. Receiver operating characteristic (ROC) analysis showed that fast K 1 trans had the highest area under the curve (AUC) than any other individual parameter. The combined four parameters from the 2TCM had a considerably higher AUC value than the combined two parameters from the Tofts model. The 2TCM may be useful for quantitative analysis of prostate DCE-MRI data and may provide new information in the diagnosis of prostate cancer.
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Chiang J, Sparks H, Rink JS, Meloni MF, Hao F, Sung KH, Lee EW. Dynamic Contrast-Enhanced MR Imaging Evaluation of Perfusional Changes and Ablation Zone Size after Combination Embolization and Ablation Therapy. J Vasc Interv Radiol 2023; 34:253-260. [PMID: 36368517 DOI: 10.1016/j.jvir.2022.10.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 09/29/2022] [Accepted: 10/28/2022] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The objectives of this study were to assess the utility of dynamic contrast-enhanced magnetic resonance (MR) imaging in quantifying parenchymal perfusional changes after embolization and to characterize the association between pharmacokinetic (PK) parameters and final microwave ablation volume. MATERIALS AND METHODS PK parameters from dynamic contrast-enhanced MR imaging were used to quantify perfusional changes in the liver after transarterial embolization of the right or left lobe in a swine liver model (n = 5). Each animal subject subsequently underwent microwave ablation (60 W for 5 minutes) of the embolized and nonembolized liver lobes. Changes in PK parameters from dynamic contrast-enhanced MR imaging were correlated with their respective final microwave ablation volumes in each liver lobe. RESULTS Microwave ablation volumes of embolized liver lobes were significantly larger than those of nonembolized liver lobes (28.0 mL ± 6.2 vs 15.1 mL ± 5.2, P < .001). PK perfusion parameters were significantly lower in embolized liver lobes than in nonembolized liver lobes (Ktrans = 0.69 min-1 ± 0.15 vs 1.52 min-1 ± 0.37, P < .001; kep = 0.69 min-1 ± 0.19 vs 1.54 min-1 ± 0.42, P < .001). There was a moderate but significant correlation between normalized kep and ablation volume, with each unit increase in normalized kep corresponding to a 9.8-mL decrease in ablation volume (P = .035). CONCLUSIONS PK-derived parameters from dynamic contrast-enhanced MR imaging can be used to quantify perfusional changes after transarterial embolization and are directly inversely correlated with final ablation volume.
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Affiliation(s)
- Jason Chiang
- Department of Radiology, Ronald Reagan UCLA Medical Center, Los Angeles, California.
| | - Hiro Sparks
- Department of Radiology, Ronald Reagan UCLA Medical Center, Los Angeles, California
| | - Johann S Rink
- Department of Clinical Radiology and Nuclear Medicine, University Hospital Mannheim, Mannheim, Germany
| | - M Franca Meloni
- Casa di Cura Igea Milano, Inteventional Radiology, Department of Radiology, Casa di Cura Igea, Milan, Italy
| | - Frank Hao
- Department of Radiology, Ronald Reagan UCLA Medical Center, Los Angeles, California
| | - Kyung H Sung
- Department of Radiology, Ronald Reagan UCLA Medical Center, Los Angeles, California
| | - Edward W Lee
- Department of Radiology, Ronald Reagan UCLA Medical Center, Los Angeles, California
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Wang W, Fan X, Yang J, Wang X, Gu Y, Chen M, Jiang Y, Liu L, Zhang M. Preliminary MRI Study of Extracellular Volume Fraction for Identification of Lymphovascular Space Invasion of Cervical Cancer. J Magn Reson Imaging 2023; 57:587-597. [PMID: 36094153 DOI: 10.1002/jmri.28423] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Lymphovascular space invasion (LVSI) is a risk factor for poor prognosis of cervical cancer. Preoperative identification of LVSI is very difficult. PURPOSE To evaluate the potential of extracellular volume (ECV) fraction based on T1 mapping in preoperative identification of LVSI in cervical cancer compared with dynamic contrast-enhanced MRI (DCE-MRI). STUDY TYPE Retrospective. SUBJECTS A total of 79 patients (median age 54 years) with cervical cancer were classified into LVSI group (n = 29) and without LVSI group (n = 50) according to postoperative pathology. FIELD STRENGTH/SEQUENCE A 3-T, noncontrast and contrast-enhanced T1 mapping performed with volume interpolated breath hold examination (VIBE) sequence, DCE-MRI applied with 3D T1-weighted VIBE sequence. ASSESSMENT Regions of interest along the medial edge of the lesion were drawn on slices depicting the maximum cross-section of the tumor. The noncontrast and contrast-enhanced T1 value of the tumor and arteries in the same slice were measured, and ECV was calculated from T1 values. The parametric maps (Ktrans , kep , and ve ) derived from DCE-MRI standard Toft's model were evaluated. STATISTICAL TESTS ECV, Ktrans , kep , and ve between groups with and without LVSI were compared using Student's t-test. The receiver operating characteristic (ROC) curve and DeLong test were used to evaluate and compare the diagnostic performance of ECV, Ktrans , kep , and ve for differentiating LVSI. P < 0.05 was considered statistically significant. RESULTS The ECV and Ktrans of the LVSI group were significantly higher than that of non-LVSI group (52.86% vs. 36.77%, 0.239 vs. 0.176, respectively), and no significant differences in Kep or ve values were observed (P = 0.071 and P = 0.168, respectively). The ECV fraction showed significantly higher area under ROC curve than Ktrans for differentiating LVSI (0.874 vs. 0.655, respectively). DATA CONCLUSION ECV measurements based on T1 mapping might improve the discrimination between patients with and without LVSI in cervical cancer, showing better performance for this purpose than DCE-MRI. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Wei Wang
- Department of Radiology, China-Japan Union Hospital of Jilin University, Changchun, Jilin Province, China
| | - Xiaofei Fan
- Department of Radiology, China-Japan Union Hospital of Jilin University, Changchun, Jilin Province, China
| | - Jie Yang
- Department of Radiology, China-Japan Union Hospital of Jilin University, Changchun, Jilin Province, China
| | - Xuemei Wang
- Department of Pathology, China-Japan Union Hospital of Jilin University, Changchun, Jilin Province, China
| | - Yu Gu
- Department of Pathology, China-Japan Union Hospital of Jilin University, Changchun, Jilin Province, China
| | - Mingxin Chen
- Inpatient Service Center, China-Japan Union Hospital of Jilin University, Changchun, Jilin Province, China
| | - Yueluan Jiang
- MR Scientific Marketing, Diagnostic Imaging, Siemens Healthineers Ltd., Beijing, China
| | - Lin Liu
- Department of Radiology, China-Japan Union Hospital of Jilin University, Changchun, Jilin Province, China
| | - Mengchao Zhang
- Department of Radiology, China-Japan Union Hospital of Jilin University, Changchun, Jilin Province, China
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Bressler I, Ben Bashat D, Buchsweiler Y, Aizenstein O, Limon D, Bokestein F, Blumenthal TD, Nevo U, Artzi M. Model-free dynamic contrast-enhanced MRI analysis: differentiation between active tumor and necrotic tissue in patients with glioblastoma. MAGMA (NEW YORK, N.Y.) 2023; 36:33-42. [PMID: 36287282 DOI: 10.1007/s10334-022-01045-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 10/09/2022] [Accepted: 10/13/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Treatment response assessment in patients with high-grade gliomas (HGG) is heavily dependent on changes in lesion size on MRI. However, in conventional MRI, treatment-related changes can appear as enhancing tissue, with similar presentation to that of active tumor tissue. We propose a model-free data-driven method for differentiation between these tissues, based on dynamic contrast-enhanced (DCE) MRI. MATERIALS AND METHODS The study included a total of 66 scans of patients with glioblastoma. Of these, 48 were acquired from 1 MRI vendor and 18 scans were acquired from a different MRI vendor and used as test data. Of the 48, 24 scans had biopsy results. Analysis included semi-automatic arterial input function (AIF) extraction, direct DCE pharmacokinetic-like feature extraction, and unsupervised clustering of the two tissue types. Validation was performed via (a) comparison to biopsy result (b) correlation to literature-based DCE curves for each tissue type, and (c) comparison to clinical outcome. RESULTS Consistency between the model prediction and biopsy results was found in 20/24 cases. An average correlation of 82% for active tumor and 90% for treatment-related changes was found between the predicted component and population-based templates. An agreement between the predicted results and radiologist's assessment, based on RANO criteria, was found in 11/12 cases. CONCLUSION The proposed method could serve as a non-invasive method for differentiation between lesion tissue and treatment-related changes.
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Affiliation(s)
- Idan Bressler
- Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,The Iby and Aladar Fleischman Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel
| | - Dafna Ben Bashat
- Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, 6 Weizmann St, 64239, Tel-Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Yuval Buchsweiler
- Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,The Iby and Aladar Fleischman Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel
| | - Orna Aizenstein
- Sackler Faculty of Medicine, Tel Aviv University, 6 Weizmann St, 64239, Tel-Aviv, Israel.,Division of Radiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Dror Limon
- Sackler Faculty of Medicine, Tel Aviv University, 6 Weizmann St, 64239, Tel-Aviv, Israel.,Division of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Felix Bokestein
- Sackler Faculty of Medicine, Tel Aviv University, 6 Weizmann St, 64239, Tel-Aviv, Israel.,Neuro-Oncology Service, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - T Deborah Blumenthal
- Sackler Faculty of Medicine, Tel Aviv University, 6 Weizmann St, 64239, Tel-Aviv, Israel.,Neuro-Oncology Service, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Uri Nevo
- The Iby and Aladar Fleischman Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Moran Artzi
- Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. .,Sackler Faculty of Medicine, Tel Aviv University, 6 Weizmann St, 64239, Tel-Aviv, Israel. .,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
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41
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Mooshage CM, Schimpfle L, Kender Z, Szendroedi J, Heiland S, Nawroth P, Bendszus M, Kopf S, Kurz FT, Jende JME. Diametrical Effects of Glucose Levels on Microvascular Permeability of Peripheral Nerves in Patients With Type 2 Diabetes With and Without Diabetic Neuropathy. Diabetes 2023; 72:290-298. [PMID: 36326808 DOI: 10.2337/db22-0548] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022]
Abstract
Clinical studies investigating the benefit of glucose control on the progression of diabetic neuropathy (DN) have come to controversial results in patients with type 2 diabetes (T2D). This study aimed to assess associations of HbA1c levels with parameters of nerve perfusion in patients with T2D with and without DN using dynamic contrast-enhanced magnetic resonance neurography (DCE-MRN) at 3 Tesla. A total of 58 patients with T2D (20 with DN and 38 without DN) took part in this cross-sectional single-center study. Groups were matched for age, BMI, HbA1c, duration of T2D, and renal function. All patients underwent DCE-MRN with subsequent electrophysiologic and serologic testing. The extended Tofts model was used to quantify the sciatic nerve's microvascular permeability (Ktrans), volume fraction of the extracapillary extracellular space, and volume fraction of the plasma space. As a main result, we found that Ktrans correlated positively with HbA1c in patients with DN, while a negative correlation between the two parameters was found in patients without DN. Our results indicate that the effect of glucose control on the capillary permeability of peripheral nerves differs between patients with T2D with and without DN.
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Affiliation(s)
- Christoph M Mooshage
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Lukas Schimpfle
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, Heidelberg, Germany
| | - Zoltan Kender
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, Heidelberg, Germany
| | - Julia Szendroedi
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, Heidelberg, Germany
| | - Sabine Heiland
- Division of Experimental Radiology, Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Peter Nawroth
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, Heidelberg, Germany
- German Center for Diabetes Research, associated partner in the DZD, München-Neuherberg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Stefan Kopf
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, Heidelberg, Germany
- German Center for Diabetes Research, associated partner in the DZD, München-Neuherberg, Germany
| | - Felix T Kurz
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
- German Cancer Research Center, Heidelberg, Germany
| | - Johann M E Jende
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
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42
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Vignon-Clementel IE, Jagiella N, Dichamp J, Kowalski J, Lederle W, Laue H, Kiessling F, Sedlaczek O, Drasdo D. A proof-of-concept pipeline to guide evaluation of tumor tissue perfusion by dynamic contrast-agent imaging: Direct simulation and inverse tracer-kinetic procedures. FRONTIERS IN BIOINFORMATICS 2023; 3:977228. [PMID: 37122998 PMCID: PMC10135870 DOI: 10.3389/fbinf.2023.977228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 02/07/2023] [Indexed: 05/02/2023] Open
Abstract
Dynamic contrast-enhanced (DCE) perfusion imaging has shown great potential to non-invasively assess cancer development and its treatment by their characteristic tissue signatures. Different tracer kinetics models are being applied to estimate tissue and tumor perfusion parameters from DCE perfusion imaging. The goal of this work is to provide an in silico model-based pipeline to evaluate how these DCE imaging parameters may relate to the true tissue parameters. As histology data provides detailed microstructural but not functional parameters, this work can also help to better interpret such data. To this aim in silico vasculatures are constructed and the spread of contrast agent in the tissue is simulated. As a proof of principle we show the evaluation procedure of two tracer kinetic models from in silico contrast-agent perfusion data after a bolus injection. Representative microvascular arterial and venous trees are constructed in silico. Blood flow is computed in the different vessels. Contrast-agent input in the feeding artery, intra-vascular transport, intra-extravascular exchange and diffusion within the interstitial space are modeled. From this spatiotemporal model, intensity maps are computed leading to in silico dynamic perfusion images. Various tumor vascularizations (architecture and function) are studied and show spatiotemporal contrast imaging dynamics characteristic of in vivo tumor morphotypes. The Brix II also called 2CXM, and extended Tofts tracer-kinetics models common in DCE imaging are then applied to recover perfusion parameters that are compared with the ground truth parameters of the in silico spatiotemporal models. The results show that tumor features can be well identified for a certain permeability range. The simulation results in this work indicate that taking into account space explicitly to estimate perfusion parameters may lead to significant improvements in the perfusion interpretation of the current tracer-kinetics models.
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Affiliation(s)
| | | | | | | | - Wiltrud Lederle
- Institute for Experimental Molecular Imaging (ExMI), University Clinic and Helmholtz Institute for Biomedical Engineering, RWTH Aachen University, Aachen, Germany
| | - Hendrik Laue
- Fraunhofer MEVIS, Institute for Digital Medicine, Bremen, Germany
| | - Fabian Kiessling
- Institute for Experimental Molecular Imaging (ExMI), University Clinic and Helmholtz Institute for Biomedical Engineering, RWTH Aachen University, Aachen, Germany
- Fraunhofer MEVIS, Institute for Digital Medicine, Aachen, Germany
| | - Oliver Sedlaczek
- Department of NCT Radiology Uniklinikum/DKFZ Heidelberg, Heidelberg, Germany
| | - Dirk Drasdo
- Inria, Palaiseau, France
- IfADo - Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
- *Correspondence: Irene E. Vignon-Clementel, ; Dirk Drasdo,
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43
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Sherminie LPG, Jayatilake ML. Fractal Dimension Analysis of Pixel Dynamic Contrast Enhanced-Magnetic Resonance Imaging Pharmacokinetic Parameters for Discrimination of Benign and Malignant Breast Lesions. JCO Clin Cancer Inform 2023; 7:e2200101. [PMID: 36745858 DOI: 10.1200/cci.22.00101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
PURPOSE Breast cancer is the most frequent cancer in women worldwide. However, its diagnosis mostly depends on visual examination of radiologic images, leading to an overdiagnosis with substantial costs. Therefore, a quantitative approach such as dynamic contrast enhanced (DCE)-magnetic resonance imaging (MRI) through pharmacokinetic (PK) modeling is required for reliable analysis. As PK parameters lack information on parameter heterogeneity, texture-based analysis is required to quantify PK parameter heterogeneity. Therefore, this study focused on determining the usefulness of fractal dimension (FD) as a potential imaging biomarker of tumor heterogeneity for discriminating benign and malignant breast lesions. METHODS Parametric maps for PK parameters, extravasation rate of contrast agent from blood plasma to extravascular extracellular space (Ktrans) and volume fraction of extravascular extracellular space (ve), were generated for the regions of interest (ROIs) under the standard model using 18 lesions. Then, tumor ROI and pixel DCE-MRI time-course data were analyzed to extract pixel values of Ktrans and ve. For each ROI, FD values of Ktrans and ve were computed using the blanket method. RESULTS The FD values of Ktrans for benign and malignant lesions varied from 2.96 to 3.49 and from 2.37 to 3.16, respectively, whereas FD values of ve for benign and malignant lesions varied from 3.01 to 5.15 and 2.42 to 3.44, respectively. There were significant differences in FD values derived from Ktrans parametric maps (P = .0053) and ve parametric maps (P = .0271) between benign and malignant lesions according to the statistical analysis. CONCLUSION Incorporating texture heterogeneity changes in breast lesions captured by FD with quantitative DCE-MRI parameters generated under the standard model is a potential marker for prediction of malignant lesions.
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Affiliation(s)
- Lahanda Purage G Sherminie
- Department of Nuclear Science, Faculty of Science, University of Colombo, Colombo, Sri Lanka.,Department of Radiography/Radiotherapy, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Mohan L Jayatilake
- Department of Radiography/Radiotherapy, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka
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44
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Sun H, Du F, Liu Y, Li Q, Liu X, Wang T. DCE-MRI and DWI can differentiate benign from malignant prostate tumors when serum PSA is ≥10 ng/ml. Front Oncol 2022; 12:925186. [PMID: 36578948 PMCID: PMC9792168 DOI: 10.3389/fonc.2022.925186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 11/21/2022] [Indexed: 12/14/2022] Open
Abstract
Background This study investigated the diagnostic utility of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging (DWI) parameters for distinguishing between benign and malignant prostate tumors when serum prostate-specific antigen (PSA) level is ≥10 ng/ml. Methods Patients with prostate cancer (PCa) and benign prostatic hyperplasia (BPH) with serum PSA ≥10 ng/ml before treatment were recruited. Transrectal ultrasound-guided biopsy or surgery was performed for tumor classification and patients were stratified accordingly into PCa and BPH groups. Patients underwent DCE-MRI and DWI scanning and the transfer constant (Ktrans), rate constant (Kep), fractional volume of the extravascular extracellular space, plasma volume (Vp), and Prostate Imaging Reporting and Data System Version 2 (PI-RADS v2) score were determined. The apparent diffusion coefficient (ADC) was calculated from DWI. The diagnostic performance of these parameters was assessed by receiver operating characteristic (ROC) curve analysis, and those showing a significant difference between the PCa and BPH groups were combined into a multivariate logistic regression model for PCa diagnosis. Spearman's correlation was used to analyze the relationship between Gleason score and imaging parameters. Results The study enrolled 65 patients including 32 with PCa and 33 with BPH. Ktrans (P=0.006), Kep (P=0.001), and Vp (P=0.009) from DCE-MRI and ADC (P<0.001) from DWI could distinguish between the 2 groups when PSA was ≥10 ng/ml. PI-RADS score (area under the ROC curve [AUC]=0.705), Ktrans (AUC=0.700), Kep (AUC=0.737), Vp (AUC=0.688), and ADC (AUC=0.999) showed high diagnostic performance for discriminating PCa from BPH. A combined model based on PI-RADS score, Ktrans, Kep, Vp, and ADC had a higher AUC (1.000), with a sensitivity of 0.998 and specificity of 0.999. Imaging markers showed no significant correlation with Gleason score in PCa. Conclusion DCE-MRI and DWI parameters can distinguish between benign and malignant prostate tumors in patients with serum PSA ≥10 ng/ml.
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Affiliation(s)
- Hongmei Sun
- Department of Magenetic Resonance Imaging (MRI), Henan Province Hospital of Traditional Chinese Medicine (The Second Affiliated Hospital of Henan University of Chinese Medicine), Zhengzhou, China,*Correspondence: Hongmei Sun,
| | - Fengli Du
- Henan University of Chinese Medicine, Zhengzhou, China
| | - Yan Liu
- School of Medical Engineering, Xinxiang Medical University, Xinxiang, China
| | - Qian Li
- Department of Magenetic Resonance Imaging (MRI), Henan Province Hospital of Traditional Chinese Medicine (The Second Affiliated Hospital of Henan University of Chinese Medicine), Zhengzhou, China
| | - Xinai Liu
- Department of Magenetic Resonance Imaging (MRI), Henan Province Hospital of Traditional Chinese Medicine (The Second Affiliated Hospital of Henan University of Chinese Medicine), Zhengzhou, China
| | - Tongming Wang
- Department of Magenetic Resonance Imaging (MRI), Henan Province Hospital of Traditional Chinese Medicine (The Second Affiliated Hospital of Henan University of Chinese Medicine), Zhengzhou, China
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45
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Sinno N, Taylor E, Hompland T, Milosevic M, Jaffray DA, Coolens C. Incorporating cross-voxel exchange for the analysis of dynamic contrast-enhanced imaging data: pre-clinical results. Phys Med Biol 2022; 67. [PMID: 36541560 DOI: 10.1088/1361-6560/aca512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 11/22/2022] [Indexed: 11/23/2022]
Abstract
Tumours exhibit abnormal interstitial structures and vasculature function often leading to impaired and heterogeneous drug delivery. The disproportionate spatial accumulation of a drug in the interstitium is determined by several microenvironmental properties (blood vessel distribution and permeability, gradients in the interstitial fluid pressure). Predictions of tumour perfusion are key determinants of drug delivery and responsiveness to therapy. Pharmacokinetic models allow for the quantification of tracer perfusion based on contrast enhancement measured with non-invasive imaging techniques. An advanced cross-voxel exchange model (CVXM) was recently developed to provide a comprehensive description of tracer extravasation as well as advection and diffusion based on cross-voxel tracer kinetics (Sinnoet al2021). Transport parameters were derived from DCE-MRI of twenty TS-415 human cervical carcinoma xenografts by using CVXM. Tracer velocity flows were measured at the tumour periphery (mean 1.78-5.82μm.s-1) pushing the contrast outward towards normal tissue. These elevated velocity measures and extravasation rates explain the heterogeneous distribution of tracer across the tumour and its accumulation at the periphery. Significant values for diffusivity were deduced across the tumours (mean 152-499μm2.s-1). CVXM resulted in generally smaller values for the extravasation parameterKext(mean 0.01-0.04 min-1) and extravascular extracellular volume fractionve(mean 0.05-0.17) compared to the standard Tofts parameters, suggesting that Toft model underestimates the effects of inter-voxel exchange. The ratio of Tofts' extravasation parameters over CVXM's was significantly positively correlated to the cross-voxel diffusivity (P< 0.0001) and velocity (P= 0.0005). Tofts' increasedvemeasurements were explained using Sinnoet al(2021)'s theoretical work. Finally, a scan time of 15 min renders informative estimations of the transport parameters. However, a duration as low as 7.5 min is acceptable to recognize the spatial variation of transport parameters. The results demonstrate the potential of utilizing CVXM for determining metrics characterizing the exchange of tracer between the vasculature and the tumour tissue. Like for many earlier models, additional work is strongly recommended, in terms of validation, to develop more confidence in the results, motivating future laboratory work in this regard.
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Affiliation(s)
- Noha Sinno
- The Institute of Biomedical Engineering (BME), University of Toronto, Toronto, Canada.,The Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Edward Taylor
- The Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Canada.,TECHNA Institute, University Health Network, Toronto, Canada
| | - Tord Hompland
- Department of Radiation Biology, Oslo University Hospital, Oslo, Norway
| | - Michael Milosevic
- The Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Canada.,Institute of Medical Science, University of Toronto, Toronto, Canada
| | - David A Jaffray
- The Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Canada.,TECHNA Institute, University Health Network, Toronto, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Canada.,University of Texas, MD Anderson Cancer Centre, Texas, United States of America
| | - Catherine Coolens
- The Institute of Biomedical Engineering (BME), University of Toronto, Toronto, Canada.,The Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Canada.,TECHNA Institute, University Health Network, Toronto, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Canada
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46
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Tadimalla S, Wang W, Haworth A. Role of Functional MRI in Liver SBRT: Current Use and Future Directions. Cancers (Basel) 2022; 14:cancers14235860. [PMID: 36497342 PMCID: PMC9739660 DOI: 10.3390/cancers14235860] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 11/30/2022] Open
Abstract
Stereotactic body radiation therapy (SBRT) is an emerging treatment for liver cancers whereby large doses of radiation can be delivered precisely to target lesions in 3-5 fractions. The target dose is limited by the dose that can be safely delivered to the non-tumour liver, which depends on the baseline liver functional reserve. Current liver SBRT guidelines assume uniform liver function in the non-tumour liver. However, the assumption of uniform liver function is false in liver disease due to the presence of cirrhosis, damage due to previous chemo- or ablative therapies or irradiation, and fatty liver disease. Anatomical information from magnetic resonance imaging (MRI) is increasingly being used for SBRT planning. While its current use is limited to the identification of target location and size, functional MRI techniques also offer the ability to quantify and spatially map liver tissue microstructure and function. This review summarises and discusses the advantages offered by functional MRI methods for SBRT treatment planning and the potential for adaptive SBRT workflows.
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Affiliation(s)
- Sirisha Tadimalla
- Institute of Medical Physics, School of Physics, Faculty of Science, The University of Sydney, Camperdown, NSW 2006, Australia
- Correspondence:
| | - Wei Wang
- Crown Princess Mary Cancer Centre, Sydney West Radiation Oncology Network, Western Sydney Local Health District, Sydney, NSW 2145, Australia
| | - Annette Haworth
- Institute of Medical Physics, School of Physics, Faculty of Science, The University of Sydney, Camperdown, NSW 2006, Australia
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Waqar M, Van Houdt PJ, Hessen E, Li KL, Zhu X, Jackson A, Iqbal M, O’Connor J, Djoukhadar I, van der Heide UA, Coope DJ, Borst GR. Visualising spatial heterogeneity in glioblastoma using imaging habitats. Front Oncol 2022; 12:1037896. [PMID: 36505856 PMCID: PMC9731157 DOI: 10.3389/fonc.2022.1037896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 10/31/2022] [Indexed: 11/26/2022] Open
Abstract
Glioblastoma is a high-grade aggressive neoplasm characterised by significant intra-tumoral spatial heterogeneity. Personalising therapy for this tumour requires non-invasive tools to visualise its heterogeneity to monitor treatment response on a regional level. To date, efforts to characterise glioblastoma's imaging features and heterogeneity have focussed on individual imaging biomarkers, or high-throughput radiomic approaches that consider a vast number of imaging variables across the tumour as a whole. Habitat imaging is a novel approach to cancer imaging that identifies tumour regions or 'habitats' based on shared imaging characteristics, usually defined using multiple imaging biomarkers. Habitat imaging reflects the evolution of imaging biomarkers and offers spatially preserved assessment of tumour physiological processes such perfusion and cellularity. This allows for regional assessment of treatment response to facilitate personalised therapy. In this review, we explore different methodologies to derive imaging habitats in glioblastoma, strategies to overcome its technical challenges, contrast experiences to other cancers, and describe potential clinical applications.
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Affiliation(s)
- Mueez Waqar
- Department of Neurosurgery, Geoffrey Jefferson Brain Research Centre, Manchester Centre for Clinical Neurosciences, Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, United Kingdom
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health and Manchester Cancer Research Centre, University of Manchester, Manchester, United Kingdom
| | - Petra J. Van Houdt
- Department of Radiation Oncology, the Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Eline Hessen
- Department of Radiation Oncology, the Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Ka-Loh Li
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health and Manchester Cancer Research Centre, University of Manchester, Manchester, United Kingdom
| | - Xiaoping Zhu
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health and Manchester Cancer Research Centre, University of Manchester, Manchester, United Kingdom
| | - Alan Jackson
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health and Manchester Cancer Research Centre, University of Manchester, Manchester, United Kingdom
- Department of Neuroradiology, Geoffrey Jefferson Brain Research Centre, Manchester Centre for Clinical Neurosciences, Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, United Kingdom
| | - Mudassar Iqbal
- Division of Informatics, Imaging and Data Sciences, Faculty of Biology, Medicine and Health and Manchester Cancer Research Centre, University of Manchester, Manchester, United Kingdom
| | - James O’Connor
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health and Manchester Cancer Research Centre, University of Manchester, Manchester, United Kingdom
- Department of Radiology, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Ibrahim Djoukhadar
- Department of Neuroradiology, Geoffrey Jefferson Brain Research Centre, Manchester Centre for Clinical Neurosciences, Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, United Kingdom
| | - Uulke A. van der Heide
- Department of Radiation Oncology, the Netherlands Cancer Institute, Amsterdam, Netherlands
| | - David J. Coope
- Department of Neurosurgery, Geoffrey Jefferson Brain Research Centre, Manchester Centre for Clinical Neurosciences, Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, United Kingdom
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health and Manchester Cancer Research Centre, University of Manchester, Manchester, United Kingdom
| | - Gerben R. Borst
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health and Manchester Cancer Research Centre, University of Manchester, Manchester, United Kingdom
- Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom
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Unsupervised Analysis Based on DCE-MRI Radiomics Features Revealed Three Novel Breast Cancer Subtypes with Distinct Clinical Outcomes and Biological Characteristics. Cancers (Basel) 2022; 14:cancers14225507. [PMID: 36428600 PMCID: PMC9688868 DOI: 10.3390/cancers14225507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/06/2022] [Accepted: 11/07/2022] [Indexed: 11/11/2022] Open
Abstract
Background: This study aimed to reveal the heterogeneity of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) of breast cancer (BC) and identify its prognosis values and molecular characteristics. Methods: Two radiogenomics cohorts (n = 246) were collected and tumor regions were segmented semi-automatically. A total of 174 radiomics features were extracted, and the imaging subtypes were identified and validated by unsupervised analysis. A gene-profile-based classifier was developed to predict the imaging subtypes. The prognostic differences and the biological and microenvironment characteristics of subtypes were uncovered by bioinformatics analysis. Results: Three imaging subtypes were identified and showed high reproducibility. The subtypes differed remarkably in tumor sizes and enhancement patterns, exhibiting significantly different disease-free survival (DFS) or overall survival (OS) in the discovery cohort (p = 0.024) and prognosis datasets (p ranged from <0.0001 to 0.0071). Large sizes and rapidly enhanced tumors usually had the worst outcomes. Associations were found between imaging subtypes and the established subtypes or clinical stages (p ranged from <0.001 to 0.011). Imaging subtypes were distinct in cell cycle and extracellular matrix (ECM)-receptor interaction pathways (false discovery rate, FDR < 0.25) and different in cellular fractions, such as cancer-associated fibroblasts (p < 0.05). Conclusions: The imaging subtypes had different clinical outcomes and biological characteristics, which may serve as potential biomarkers.
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Jiang M, Song X, Zhang H, Tao X, Yang G, Wang Y, Liu Y, Zhou H, Sun J, Li Y. The combination of T2-mapping value of lacrimal gland and clinical indicators can improve the stage prediction of Graves' ophthalmopathy compared to clinical activity scores. Endocrine 2022; 78:321-328. [PMID: 35997966 DOI: 10.1007/s12020-022-03167-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 08/06/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE To explore radiological changes of the lacrimal gland (LG) in Graves' ophthalmopathy (GO) and whether a combination of MRI parameters and clinical indicators would be more effective in predicting individual clinical manifestation of GO compared to clinical activity scores (CAS) assessment. METHODS A total of 28 patients with GO (56 eyes) and 14 healthy controls (HCs) (28 eyes) were enrolled between July 2020 and July 2021. Patients were classified into the active GO group (CAS ≥ 3) and the inactive GO group (CAS < 3). MRI data and clinical data of LG were collected. The diagnostic performance of MRI parameters and models was assessed by receiver operating characteristic curve analysis. Logistic regression predictive models for staging GO were compared. RESULTS LG in GO groups had significantly higher Ktrans, Ve, IAUC, ADC, and T2-mapping values (p = 0.006, p < 0.001, p < 0.001, p = 0.048, and p = 0.001, respectively), and significant lower Kep and Vp values (p < 0.001 and p < 0.001 respectively). There were statistically significant differences in T2-mapping value (p < 0.001), the proportion of mild or no obvious redness of conjunctiva (p < 0.001), and the proportion of swelling of caruncle or plica (p < 0.001) between inactive and active groups. In MRI based logistic regression model, the T2-mapping value was an independent risk factor (AUC = 0.832). When combining MRI and clinical indicators, T2-mapping value and age resulted in independent risk factors (AUC = 0.928). Swelling of eyelids, redness of the conjunctiva, swelling of the conjunctiva, swelling of caruncle or plica, and spontaneous retrobulbar pain could be replaced by other objective indicators (AUC = 0.937, 0.852, 0.876, 0.896, and 0.891, respectively). CONCLUSION There were significant differences in MRI quantitative parameters of LG between HCs and GO patients. The combination of the T2-mapping value of LG and clinical indicators improved the stage prediction of Graves' ophthalmopathy compared to CAS, thus providing a new idea for enhancing the objectification level of GO data collection.
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Affiliation(s)
- Mengda Jiang
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No.639 Zhizaoju Road, Shanghai, 200011, China
| | - Xuefei Song
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, 200011, China
| | - Haiyang Zhang
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, 200011, China
| | - Xiaofeng Tao
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No.639 Zhizaoju Road, Shanghai, 200011, China
| | - Gongxin Yang
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No.639 Zhizaoju Road, Shanghai, 200011, China
| | - Yishi Wang
- Philips Healthcare, Beijing, 100600, China
| | - Yuting Liu
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, 200011, China
| | - Huifang Zhou
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, 200011, China
| | - Jing Sun
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, 200011, China.
| | - Yinwei Li
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, 200011, China.
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50
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Dickie BR, Jin T, Wang P, Hinz R, Harris W, Boutin H, Parker GJ, Parkes LM, Matthews JC. Quantitative kinetic modelling and mapping of cerebral glucose transport and metabolism using glucoCESL MRI. J Cereb Blood Flow Metab 2022; 42:2066-2079. [PMID: 35748031 PMCID: PMC9580170 DOI: 10.1177/0271678x221108841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Chemical-exchange spin-lock (CESL) MRI can map regional uptake and utilisation of glucose in the brain at high spatial resolution (i.e sub 0.2 mm3 voxels). We propose two quantitative kinetic models to describe glucose-induced changes in tissue R1ρ and apply them to glucoCESL MRI data acquired in tumour-bearing and healthy rats. When assuming glucose transport is saturable, the maximal transport capacity (Tmax) measured in normal tissue was 3.2 ± 0.6 µmol/min/mL, the half saturation constant (Kt) was 8.8 ± 2.2 mM, the metabolic rate of glucose consumption (MRglc) was 0.21 ± 0.13 µmol/min/mL, and the cerebral blood volume (vb) was 0.006 ± 0.005 mL/mL. Values in tumour were: Tmax = 7.1 ± 2.7 µmol/min/mL, Kt = 14 ± 1.7 mM, MRglc = 0.22 ± 0.09 µmol/min/mL, vb = 0.030 ± 0.035 mL/mL. Tmax and Kt were significantly higher in tumour tissue than normal tissue (p = 0.006 and p = 0.011, respectively). When assuming glucose uptake also occurs via free diffusion, the free diffusion rate (kd) was 0.061 ± 0.017 mL/min/mL in normal tissue and 0.12 ± 0.042 mL/min/mL in tumour. These parameter estimates agree well with literature values obtained using other approaches (e.g. NMR spectroscopy).
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Affiliation(s)
- Ben R Dickie
- Division of Neuroscience and Experimental Psychology, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.,Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Manchester, UK
| | - Tao Jin
- Department of Radiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Ping Wang
- Department of Radiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Rainer Hinz
- Division of Informatics, Imaging, and Data Science, Faculty of Biology Medicine and Health, University of Manchester, Manchester, UK
| | - William Harris
- Division of Neuroscience and Experimental Psychology, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.,Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Manchester, UK
| | - Hervé Boutin
- Division of Neuroscience and Experimental Psychology, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.,Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Manchester, UK
| | - Geoff Jm Parker
- Bioxydyn Limited, Manchester, UK.,Centre for Medical Image Computing, Department of Medical Physics & Biomedical Engineering and Department of Neuroinflammation, University College London, London, UK
| | - Laura M Parkes
- Division of Neuroscience and Experimental Psychology, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.,Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Manchester, UK
| | - Julian C Matthews
- Division of Neuroscience and Experimental Psychology, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.,Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Manchester, UK
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